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R Aleksandrov

Publications and source records attributed to R Aleksandrov.

18 recordsLinked to original sources
PubMed1992

Pulsed Doppler assessment of left ventricular diastolic function in atrial septal defect.

From January 1986 through December 1990, we used pulsed Doppler echocardiography to evaluate left ventricular diastolic function in 43 patients with an ostium secundum atrial septal defect. The study population included 27 females and 16 males, whose ages ranged from 6 to 58 years (mean, 26 years). The patients were grouped according to degree of pulmonary hemodynamic impairment: patients in Group 1 (n = 6) had severe pulmonary hypertension, those in Group 2 (n = 10) had mild-to-moderate pulmonary hypertension, and those in Group 3 (n = 27) had no pulmonary hypertension. For comparison, we also evaluated 30 healthy individuals. All control subjects had a normal left ventricular filling profile. Of the 43 study patients, 8 (19%) showed Doppler echocardiographic signs of impaired left ventricular relaxation, including a prolonged left ventricular isovolumic relaxation time, decreased peak left ventricular diastolic inflow velocity, and a prolonged mean deceleration time of early diastolic flow velocity. Of these 8 patients, 5 were from Group 1, 1 was from Group 2, and 2 were from Group 3. A positive correlation (r = 0.66; standard error of the estimate = 0.32) was found between the late-to-early left ventricular diastolic inflow velocity ratio and the pulmonary-to-systemic vascular resistance ratio. Our results showed impaired left ventricular relaxation in 8 (19%) of patients with atrial septal defect; 5 of these patients had severe pulmonary hypertension. We therefore conclude that left ventricular diastolic dysfunction is closely related to severe pulmonary hypertension.

Journal Article↗
PubMed1989

Doppler echocardiographic analysis of the transmitral flow velocity profile in patients with ventricular septal defects.

Using continuous-wave Doppler echocardiography, we evaluated the mitral flow velocity pattern in 30 ventricular septal defect patients, 11 of whom had severe pulmonary vascular obstructive disease (Group I); 10 of whom had severe pulmonary hypertension without pulmonary vascular obstructive disease (Group II); and 9 of whom had no pulmonary hypertension and hemodynamically unimportant left-to-right shunts (Group III). In addition, 25 healthy subjects (Group IV) were studied for comparative purposes. The peak velocity of early left ventricular filling (E) was significantly lower in Group I than in all the other groups (p < 0.01). The peak velocity of late left ventricular filling (A) was significantly higher (p < 0.01) in Group I than in Group III, or than in normal individuals (Group IV) (p < 0.01). The ratio A/E was the most prominent difference between Group I patients and the other groups, with Group I having a significantly higher ratio (p < 0.01), which was 1 or greater in 9 of 11 patients. In contrast, none of the remaining ventricular septal defect patients or normal subjects had an A/E ratio of 1 or greater. Group II had increased mitral flow velocities, while Group III had normal mitral flow velocity profiles. A positive correlation between the magnitude of the left-to-right shunt and early mitral flow velocity peak (r = 0.86) and late peak (r = 0.81) was found, regardless of the degree of pulmonary hypertension. These results indicate that significant alterations of the mitral flow velocity pattern, which mimic the abnormalities associated with impaired left ventricular diastolic function (A/E ratio of 1 or greater), occur in ventricular septal defect patients who have severe pulmonary vascular obstructive disease. The transmitral velocity profiles in the ventricular septal defect patients without severe pulmonary vascular obstructive disease were similar to those of the normal patients, although the values relative to the degree of left-to-right shunting were higher in the ventricular septal defect patients.

Journal Article↗
PubMed1981

[Heart valve replacement].

From 1965 to 1980, the authors accumulated vast experience by operating on 2500 diseased heart valves. Some of these patients had one, two, or three valves replaced. Among the two/three patients, there was a monovalvular problem in III, and more than half the patients with multivalvular problems in IV functional group NYHA. In group II there were only one/three patients with stenosis of the aortic valve. Because of the advanced stage of the disease among the group II patients, the following conditions were often present: heart insufficiency, manifest lung hypertension, cardiomegaly, and pronounced arrhythmia with damage to the kidneys. The risk in such cases is significantly greater. In total, 2941 valves were built. 74% had a normal postoperative recovery, 9,2% died; and 14,2% suffered complications that were remedied. Among the complications were insufficiency of the heart, arrhythmia, hemorrhage, transitory cerebral damage, and tracheobronchial infections. Thus, it can be seen that valve replacement as a treatment for significant hemodynamic disturbances is an effective method of surgical treatment. Improved results, reduction of complications, and few fatalities signal the advancement in such treatment.

Heart Valve Diseases↗
PubMedDate not supplied

Bidirectional shunt flow across a ventricular septal defect: pulsed Doppler echocardiographic analysis.

Pulsed Doppler echocardiographic and hemodynamic examinations were performed in 31 patients (mean age 17.8 years) with isolated ventricular septal defect (VSD). Three groups were studied: group I (n = 6) patients had severe pulmonary vascular obstructive disease (PVOD); group II (n = 12) patients had pulmonary hypertension (PH) without severe PVOD; group III (n = 13) patients had no PH. Bidirectional shunting was detected in 9 VSD patients (6 in group I and 3 in group II). Patients with low to moderately elevated right ventricular pressures demonstrated left-to-right shunting across the defect throughout the cardiac cycle. When systolic pressure in the right ventricle reached approximately 60% of the left ventricular pressure, right-to-left shunting occurred across the defect during early and mid diastole. However, in patients with Eisenmenger syndrome (group I) the right-to-left shunting occurred during late systole with continuation during the early and mid diastolic period. The earlier occurrence of right-to-left shunting (index < 0.5 second) signifies the presence of severe PVOD.

Adolescent↗
PubMedDate not supplied

[Infections of the sternum after cardiac surgery].

Methods of treatment of suppurative mediastinitis in cardiosurgical operations applied at the clinic are analysed. These methods are: debridment with closure of the sternum with irrigation of the substernal space, debridment with bandage of open wound and healing per secundam, debridment with bandage of open wound and its closure by myocutaneous layers. It has been concluded that these infections are very complex etiopathogenetically because of which it is very important to know all relevant risk factors aiming to prevent development of this complication in cardiosurgical operations. Its early recognition is necessary.

Adult↗