[Surgical treatment of leiomyosarcoma of the pulmonary artery under artificial circulation].
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Biomedical subjects
Publications and source records attributed to G O Lur'e.
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The model of hemorrhagic shock in dogs was used to show that the infusion of "Modegel" normalizes the arterial pressure, substantially increases the minute volume of blood circulation. The circulating blood volume rises up to the initial level at the expense of the increased plasma volume. "Modegel" gives stable correction of the acid-base balance of blood. In clinic "Modegel" was used for filling the apparatus of artificial circulation and compared with the blood substitute "Gelatinol" for operations on the open heart. Examinations of the patients have shown that "Modegel" unlike "Gelatinol" does not induce hypercalcemia and hyperosmolarity of plasma while moderate hyperoncoticity of plasma is responsible for the circulating blood volume and favorable conditions for microcirculation.
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The article deals with the results of using ultrafiltration hemoconcentration in 649 operations conducted on the open heart with extracorporeal circulation at the All-Union Scientific Center of Surgery, USSR AMS during 1983-1989. The method allows control of hemodilution and colloid-osmotic pressure of plasma during the indicated interventions, lessens the loss of blood, and reduces the expenditure of donor blood.
Venous plasma middle molecule compounds (MMC) were determined in 63 cardiosurgical patients, operated on for acquired heart diseases or coronary disease, with assisted circulation (AC) and with or without blood ultrafiltration (BUF). Intraoperative MMC level was superior to that of normal donors, and tended to decrease during AC, while BUF had basically no effect on MMC content, in spite of the latter's withdrawal with the ultrafiltrate.
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Fifteen patients were operated on for aortic aneurysms and were fitted with prostheses of the thoracoabdominal portion of the aorta in March 1997-February 1999. The operations were performed under conditions of a left atrial-femoral bypass with a centrifuge pump with a working heart. The patients were divided into 2 groups. In group 1 (10 pts), standard extracorporeal shunting and Cell-Saver were used, in group 2 (5 pts) the extracorporeal contour included an original system for rapid collection and return of autoblood. A left-atrial bypass prevented ischemia of the organs of the abdominal cavity and lower part of the body. Incorporation of a system for rapid collection and return of autoblood into the extracorporeal contour maintained stable hemodynamics, decreased heparin dose, preserved autoblood, and decreased the amount of transfused donor blood and its components.
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