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Biomedical subjects

S E Naumenko

Publications and source records attributed to S E Naumenko.

13 recordsLinked to original sources
PubMed1992

[Intrapleural hemorrhages after the correction of acquired heart defects under hypothermia without perfusion].

The authors conducted a retrospective analysis of the case records of 757 patients who underwent correction of acquired heart valvular disease under conditions of hypothermia without perfusion. Intrapleural hemorrhage occurred in the postoperative period in 43 (5.7%) patients, in 35 of them rethoracotomy had to be performed to arrest the bleeding. In patients with aortal valvular diseases a relation was revealed between the postoperative blood loss and the patient's age, the volume of operative blood loss (reverse correlation), and total dose of protamine sulfate (direct correlation), in patients with mitral valvular diseases the postoperative blood loss was related to the volume of diuresis in the first postoperative day (direct correlation). It is concluded that defective surgical hemostasis is the main cause of intrapleural hemorrhages after correction of acquired valvular diseases of the heart under conditions of hypothermia without perfusion.

Adolescent↗
PubMed1991

[Effect of various factors on the lungs after operations with non-perfusion hypothermia].

Correction of the acquired defect of the mitral valve was performed in 89 patients on the open heart under conditions of nonperfusion hypothermia. Roentgenological assessment of the lung state was used in the postoperative period. Typical morphofunctional alterations were detected after operations under conditions of nonperfusion hypothermia. It was found that the increased volume of +blood transfusions more than 19 ml/kg of the patient's body weight was followed by a reliably increased frequency and degree of ++roentgenological symptoms of injuries of the lungs.

Adult↗
PubMed1991

[Methods to decrease the blood loss during operations under hypothermia without perfusion].

The work analyzes causes of high blood loss in operations under conditions of nonperfusion deep hypothermia. It was found to be related with the division of massive adhesions in the preocclusive period and with the presence of prolonged heparinemia after occlusion. A combination of a minimal trauma of adhesions, reliable surgical hemostasis, early suturing the wound of the chest and early neutralization of activity of heparin allowed the operation blood loss to be 2.4 times less and the postoperative blood loss--2.7 times less.

Blood Loss, Surgical↗
PubMed1991

[Reconstructive operations in mitral insufficiency under whole-body hypothermia (27-25 degrees C) without perfusion].

The article discusses the results of reconstructive valve-preserving operations in mitral insufficiency performed under conditions of hypothermic (27-25 degrees C) protection without perfusion in 114 patients. Depending on the valve morphological changes multicomponent intervention was under taken contemplating the performance of commissurotomy, chorda fenestration, resection and sewing of the cusps, removal of fibrous deposits from the cusps, resection of peripheral and intermediate chordae. The discrepancy between the cusp area and the perimeter of the fibrous ring was corrected in 99 patients by annuloplasty with sutures. The hospital mortality was 6.1%. Six-year postoperative survival was recorded in 91% of cases; no thromboembolic complications encountered in 97.4% of patients. The condition improved in most patients and they moved to NYHA Functional Class I-II. Unfavourable results were due to a severe initial clinical and functional condition and to the operations conducted in the active stage of septic endocarditis.

Adult↗
PubMed1990

[Pathological sequelae of blood transfusion during hypothermia].

Under analysis was the influence of two factors--blood loss (intraoperative and postoperative) and blood substitution--upon the frequency of postoperative complications in patients with acquired mitral heart diseases operated upon under conditions of non-perfusion hypothermia. A conclusion is made that hemotransfusion during operations performed under conditions of "dry" heart and non-perfusion hypothermia should be performed but in anemia threatening by hemic hypoxia.

Blood Volume↗
PubMed1990

[Causes of increased intraoperative blood loss during operations on "dry" heart under deep hypothermia in patients with acquired heart defects].

Based on an examination of 100 patients with acquired heart diseases operated upon under conditions of nonperfusion hypothermia (28-24 degrees C) the authors have proved the key role of the square of the wound surface of the injury of the chest wall and traumatized (dissected) adhesions as well as time of circulation of heparin in blood at the stages of nonperfusion heating facilitating increased blood loss.

Adult↗
PubMed1989

[Emergency correction of traumatic mitral valve insufficiency under craniocerebral hypothermia].

Data of emergency correction of traumatic mitral insufficiency in 15 patients after closed mitral commissurotomy under conditions of craniocerebral hypothermia without artificial blood circulation are presented. Prostheses of the mitral valve were made in 3 patients, plastic valve-preserving interventions--in 12 patients. One patient died. The authors consider that in most cases with traumatic insufficiency of the mitral valve after closed commissurotomy it is possible to perform valve-preserving operations, craniocerebral hypothermia being a reliable method of their maintenance.

Adult↗
PubMedDate not supplied

[Open-heart surgery without the use of donor blood].

Blood transfusions were not performed intra- or postoperatively in 10 patients operated on for acquired heart valve defects under perfusion-free hypothermia (PFH). The otherwise favourable postoperative period was characterized by a moderate decrease in hemoglobin level and red blood cell count. No complications have been observed. It has been concluded that the volume of the blood transfused can be considerably reduced or in some cases there can be no transfusions at all during surgery under PFH.

Adult↗
PubMedDate not supplied

[A case of long-term occlusion in craniocerebral hypothermia].

A case of urgent application of craniocerebral hypothermia (CCH) during correction of traumatic mitral insufficiency developing in the course of closed mitral commissurotomy is described. The occlusion duration was 46.5 min, with the temperature in the esophagus 30.2 degrees C. No postoperative neurological disturbances have been observed. Three years after surgery the patient was in a satisfactory condition. It is demonstrated that CCH is associated with a more marked antihypoxic effect, than it has been earlier believed, and that it is possible to use intravenous ketamine anesthesia during CCH in patients with low cardiac output syndrome.

Adult↗
PubMedDate not supplied

[Early neutralization of heparin during heart surgery of acquired heart defects using perfusion-free hypothermia (28-24C)].

The analysis of blood loss in profound perfusion-free hypothermia has shown that its main cause is that heparin neutralization was performed only after the warming of a patient to 34-35 degrees C. The results of in vitro studies have shown that heparin was effectively neutralized by protamine sulfate at room temperature (20 degrees C). Using protamine sulfate, heparin neutralization was performed at 25-27 degrees C in 90 patients, which reduced blood loss by 10-15% of the circulating blood volume and made it possible to avoid hemotransfusions in the post-operative period.

Cardiac Surgical Procedures↗
PubMedDate not supplied

[Emergency craniocerebral hypothermia in the management of open mitral commissurotomy].

Craniocerebral hypothermia was used during open-heart surgery in 69 patients with mitral stenosis (hospital mortality rate 2.9%). Indications for open-heart surgery (left atrial thrombosis, mitral valve calcinosis, onset of traumatic mitral insufficiency) were determined intraoperatively during closed mitral commissurotomy. Some pathophysiological peculiarities of craniocerebral hypothermia were studied. A decrease in brain temperature and total oxygen consumption (up to 27.7% of the basic metabolism level) has been observed. Prolongation (up to 25 min) of major vessel occlusion had no negative effect on the patients' condition, postoperative complications and lethality. Craniocerebral hypothermia is considered to be a safe and effective technique indicated in case of emergency for open-heart surgery.

Adult↗
PubMedDate not supplied

[Central hemodynamics during correction of acquired aortic defects without artificial blood circulation].

The article discusses the results of study of central hemodynamics in patients with acquired aortic valvular diseases who were operated on under conditions of hypothermia without perfusion. The minute circulation volume reduced at a temperature of 26.8 degrees C to 63% of the initial level. The stroke volume did not change practically. The changes of the values of central hemodynamics in the stages of hypothermia (active and passive cooling) were irregular in character. No essential inhibiting effect of hypothermia on the cardiovascular activity was noted.

Adolescent↗