[Late results in the surgical treatment of patients with cardiac myxoma].
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Biomedical subjects
Publications and source records attributed to M A Nechaenko.
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The application of the intra-aortal counter-pulsation in the complex treatment of 37 patients was followed by stabilization of hemodynamics in 67,6% of cases, 37,8% of the patients survived. The intra-aortal counter-pulsation used in the preoperative period resulted in the survival of 50% of patients. The beginning of the procedure during the operation or in the postoperative period gave the survival of 40,9% and 22,2% of the patients correspondingly. Complications in the performing of the intra-aortal counter-pulsation were noted in 27% of cases.
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The article analyses arrhythmias recorded in the hospital period in patients with various disorders of atrioventricular conduction in continous asynchronous stimulation of the heart. The frequency with which the competitive rhythm occurred in implantation of 134 asynchronous cardiostimulants was 11.9%. Mortality from its development was 18.8%. The authors believe unjustified widening of the scope of indications for asynchronous stimulation of the heart to be one of the main causes of parasystole. Strict adherence to these indications in conducive to marked decrease in the incidence of this complication but does not rule it out completely. Implantation of biocontrolled cardiostimulants, in cases with corresponding indications, is the optimum method for the prevention of competitive rhythm.
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In 168 cases of heart myxoma histological and electron-microscopic examination have revealed signs of embryonal endothelium capable of vasoformation and glycoprotein and glycosaminoglycanes synthesis in myxoma cells. Neither differentiation of myxomas cells up to mature endotheliocytes no signs of malignant transformation was found. According to the authors, heart myxoma is a true benign dysontogenetic tumor originating from embryonal endothelium. The term myxoma does not reflect morphological entity of the tumor and the authors suggest to call it embryonal endocardial endothelioma.
A case of familial heart myxoma in 4 members of one family combined with myxomic (hamartomatous) syndrome is reported. The tumor in a proband was characterized with a multiple growth in various heart chambers. Five operations were made in the proband for 16 years and seven myxomas of different locations were removed. Myxomas originating from the endocardium of the interatrial septum oval hole were removed in 3 members of his family. The case confirms the conception of heart myxoma origin from endothelial hamartia of the endocardium.
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