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Biomedical subjects

M A Nasedkina

Publications and source records attributed to M A Nasedkina.

16 recordsLinked to original sources
PubMed1991

[Surgical tactics in critical stenosis and atresia of the pulmonary artery with intact interventricular septum in infants under 1 year of age].

The article analyses experience in surgical treatment of critical stenosis and atresia of the pulmonary artery with an intact interventricular septum in 53 infants. The patients were divided into two groups: group A--26 patients with a hypoplastic cavity of the right ventricle (RV), and group B--27 patients with a normal RV cavity. In group A, 15 patients underwent transpulmonary valvulotomy in combination with subclavian-pulmonary anastomosis by means of a Gortex prosthesis, 6 were subjected to isolated transpulmonary valvulotomy, and 5 patients underwent reconstruction of the RV outlet tract under conditions of extracorporeal circulation. In group B, 3 patients were treated by transpulmonary valvulotomy and subclavian-pulmonary anastomosis with a Gortex prosthesis, 16 by isolated valvulotomy, and 8 patients by reconstruction of the RV outlet tract under extracorporeal circulation. Six (22.2%) patients in group B died; 18 (69.2%) patients in group A died. Experience shows that in patients with critical stenosis of the pulmonary artery without RV hypoplasia preference is given to transpulmonary valvulotomy with occlusion of the venae cavae or, in marked infundibular stenosis of the RV--to reconstructive operation on the RV outlet tract under conditions of extracorporeal circulation. Transpulmonary valvulotomy in combination with subclavian-pulmonary anastomosis is advisable in patients with atresia or critical stenosis of the pulmonary artery and RV hypoplasia.

Critical Care↗
PubMed1990

[Causes of death in patients with coarctation of the aorta operated on after the age of 35].

The article analyses the causes of death of 60 patients with coarctation of the aorta who were operated on after the age of 35 in the period between 1962 and 1988. In the immediate postoperative period the mortality was 8.3%. Fifty-one patients were examined in late-term postoperative periods of up to 24 years. Twelve (23.5%) patients died from cardiovascular diseases; ischemic heart disease was found in 39.2% and residual hypertension in 41.2% of cases. Eight gross preparations of the hearts of patients who died at the clinic were examined with histological study of the myocardium and coronary vessels.

Age Factors↗
PubMed1989

[Quantitative evaluation of hypoplasia of the heart ventricles and its significance for heart surgery].

The quantitative anatomy and morphology of hypoplastic ventricles were studied in 28 afflicted hearts (15 with left ventricular hypoplasia, 13 with right ventricular hypoplasia). The control comprised 10 normal heart specimens. All the 38 specimens were studied morphometrically; this was complemented with angiocardiometry and ventricular volume estimations in diagnosing right ventricular hypoplasia. Based on the study results, the morphometric criteria of ventricular hypoplasias and their variant forms were established. The linear characteristics were found to be informative enough both in hypoplasia diagnosis and in its degree assessment. To choose a therapeutic method, two degrees of right ventricular hypoplasia were distinguished. Radical correction aimed at eliminating concomitant conditions was found to be feasible and performed in 27 patients with moderate right ventricular hypoplasia.

Heart Defects, Congenital↗
PubMed1988

[Characteristic features of the pathological anatomy and involvement of the myocardium in anomalous branching of the left coronary artery from the pulmonary trunk (Clinico-anatomical comparisons)].

Pathologic, clinical and anatomical correlations are presented for left ventricular affection in abnormal origin of the left coronary artery from the pulmonary trunk. It was revealed that there is a complex of critical factors essential for survival of patients and clinical pattern of the defect including the degree of manifestation of intercoronary collateral circulation, specificity of myocardial left ventricular ischemic impairment and that of mitral structure. Clinical and anatomical comparisons are drawn between the degree of affection of the left ventricular myocardium and its functional capacity.

Adolescent↗
PubMed1988

[Atresia of the pulmonary artery with intact intraventricular septum].

Cardiological studies of 16 patients with atresia of the pulmonary artery (APA) and intact interventricular septum (IIS) provided evidence for the following inferences: 1) most hearts in this pathology are characterized by right ventricular (RV) hypoplasia which determines structural defects of the ventricle dependent in their severity on restriction capacity of the right atrioventricular valve and time from the onset of reduced RV blood flow 2) common anatomical features of the defect are complete RV obstruction due to valvular atresia, IIS and normal shape of the conus, RV myocardial hypertrophy 3) survival of the patients conditioned by interatrial communication and open arterial canal. According to the authors, there are three types of APA with IIS. Type I--normal right ventricle with distinct components: sinuous, conical, trabecular. Type II--hypoplastic right ventricle with blocked function of the trabecular component. Type III--right ventricle affected by advanced hypoplasia and with operable sinuous part only.

Angiocardiography↗
PubMed1988

Ruptured congenital aneurysm of the sinus of Valsalva. Clinical manifestations, diagnosis, and results of surgical corrections.

An experience with the management of 27 cases of ruptured sinus of Valsalva aneurysm is reported from the Bakulev Institute of Cardiovascular Surgery, Moscow. The right coronary sinus was involved in 23 cases and the noncoronary sinus in four cases. Rupture into the right ventricle occurred in 19 cases, whereas eight ruptures entered the right atrium. Twelve patients had a ventricular defect, and 10 patients had aortic regurgitation, requiring leaflet suspension in five patients or valve replacement in five patients. The surgical management and results are presented.

Adolescent↗
PubMed1986

[Pulmonary artery stenosis with an intact interventricular septum].

15 hearts with pulmonary artery stenosis with an intact interventricular septum (PAS with IIVS) were studied morphologically and morphometrically. The results were evaluated separately according to the type of the defect: with a noncomplicated valvular stenosis of pulmonary artery (PA); with a combined valvular and infundibular stenosis of PA. Every of these types of PAS with IIVS has characteristic features of morphological structure and all possess common anatomical signs: constriction at one of the levels of circulation from the right ventricle to the lesser circulation, normal geometric structure of the cone and myocardial hypertrophy of the right ventricle. Leading cause of the obstruction of the right ventricle effluent part, regardless of the PAS with IIVS type, is a hypertrophy of the supraventricular crest and its parietal projection. As distinct from the defects on the conus-truncus, complex of PAS with IIVS is characterized by a normal spatial orientation of the supraventricular crest.

Child↗
PubMed1982

[Atresia of the right atrioventricular ostium].

Thirteen heart preparations with atresia of the right atrio-ventricular orifice (ARAVO) were examined. The ARAVO implies a congenital heart defect characterized by the lack of direct anatomical contact between the right atrium and the right ventricle, the presence of interatrial passage, the only left atrio-ventricular orifice connecting the left atrium with the only ventricular chamber. As indicated by the results of the study, "the right ventricle" in ARAVO contains no sinus part and, therefore, cannot be regarded as a ventricle. It is a rudimentary chamber. The above data indicate that a heart with one ventricle is the only ventricle. The typical findings in the ventricular (infundibular septum) and rudimentary (complete lack of the inflow part) chambers allow the anatomic essence of the defect to be regarded from new viewpoint and to consider a possibility of performing new operations, anatomo-physiological in nature, in contrast to "hemodynamical" performed previously.

Aorta↗
PubMedDate not supplied

[Modern computer data base "necropsy protocol": potential and prospects].

Basic principles in developing computer variant of necropsy protocol with wide illustrative possibilities are presented. Perspectives in the use of this information base for research and practice and for teaching the staff of the research and clinical institutions are demonstrated.

Autopsy↗
PubMedDate not supplied

[Angiocardiographic and echocardiographic diagnosis of complete transposition of great vessels in association with pathology of the aorta].

The article analyses experience in the diagnosis of a pathological condition of the aorta in complete transposition of the great vessels (CTGV) in infants. Pathology of the aorta was revealed in 9 (2.6%) of the 350 patients who were examined. Six patients with CTGV had coarctation of the aorta (CA), 2 had subaortic stenosis, and one patient had complete interruption of the arch of the aorta. Our experience provides evidence that two-dimensional echocardiography allows the region of the thoracic aorta to be located from a suprasternal or a high right parasternal approach. Subaortic stenosis was diagnosed in 2 patients during autopsy. Retrospective analysis of the echocardiograms and angiocardiograms revealed characteristic signs of subaortic obstruction. Absence of the continuity of the arch and descending aorta is an echocardiographic sign of interruption of the arch of the aorta which was recognized retrospectively only after angiocardiography. Right and left ventriculography must be performed for precise anatomical diagnosis of CTGV with an intact interventricular septum combined with coarctation of the aorta. In patients with concomitant interventricular septal defect this examination is supplemented by antegrade and retrograde aortography from the ascending aorta to exclude patent ductus arteriosus and for better visualization of CA. Catheterization of all heart cavities, right and left ventriculography, aortography, and pulmonary arteriography must be carried out in all patients with total interruption of the continuity of the arch of the aorta.

Angiocardiography↗
PubMedDate not supplied

[Diagnosis of hypoplasia of the heart ventricles: role of morphometry and morphology in its assessment].

The article deals with the results of the study of the quantitative anatomy and morphology of hypoplastic ventricles. The object of study were 28 specimens of the heart: 15 with hypoplasia of the left ventricle and 13 with hypoplasia of the right ventricle. The control group was composed of 10 specimens of normal hearts. Morphometry was conducted in all of the 28 specimens. At the same time angiocardiometry and calculations of the volume characteristics of the ventricles were undertaken in the diagnosis of hypoplasia of the right ventricle. The morphometric criteria of hypoplasia of the heart ventricles and their morphological variants were determined as a result. It was found that the lineal characteristics of the heart yielded sufficient information both for the diagnosis of hypoplasia and for determining its degree. Morphometry showed that constant ratios exist between the diameters of the atrioventricular valves and the lineal sizes of the ventricles in normal and pathological hearts. Knowledge of the aforesaid is of much practical importance because having determined the sizes of the atrioventricular valves during echocardiography one may calculate all linear characteristics of the heart and evaluate the sizes of the ventricles by means of the quantitative criteria. The article gives the method of such calculation, while its results are evidence of the high precision of the suggested constants.

Echocardiography↗
PubMedDate not supplied

[Angiocardiographic diagnosis of ventricular septal defects in complete transposition of great vessels].

The article analyses experience in angiocardiographic diagnosis of the localization of ventricular septal defects (VSD) in 47 patients with complete transposition of the great vessels (CTGV) and high pulmonary hypertension. Axial X-ray views ("4 chambers" and "long axis") were used in the examination. The work shows the angiographic signs of all types of VSD. It is concluded that at present there is no single X-ray view universal for all types of VSD. Two-dimensional echocardiography is important in the choice of the view in angiocardiography. The muscular type of VSD is encountered most frequently (40.5%) in CTGV. Absence of contact of the superior margin of the defect with the valve of the aorta and pulmonary artery is a characteristic angiocardiographic sign of the defect. Contact of the superior margin of the defect with the valve of the pulmonary artery and absence of contact with the aortic valve are characteristics of the perimembranous types of VSD. Subarterial types of VSD are characterized by contact of the upper margin of the defect both with the aortic valve and the valve of the pulmonary artery. In 11 patients the results of angiocardiography were compared with the findings of autopsy.

Angiocardiography↗
PubMedDate not supplied

[Characteristics of the radical correction of Fallot's tetralogy in anomalous distribution of the coronary arteries].

The variants of distribution of the coronary arteries were studied on 41 specimens of the heart with Fallot's tetralogy. The typical topography of the coronary arteries in this cardiac defect is characterized by counterclockwise rotation of the coronary sinuses, dominant system of the right coronary artery with a large infundibular branch, and right type of heart blood supply. There were 6 variants of anomalies of the coronary arteries. The most characteristic of Fallot's tetralogy were: a single coronary artery, origin of the large infundibular artery by an independent orifice, and anomalous origin of the anterior interventricular branch from the right coronary artery. The peculiarities of radical correction of the tetralogy in atypical distribution of the coronary arteries were discussed on the basis of analysis of 27 operations conducted with the use of non-traditional methods of correction.

Adolescent↗