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Biomedical subjects

V A Sandrikov

Publications and source records attributed to V A Sandrikov.

At least 19 recordsLinked to original sources
PubMed2006

[Surgical treatment of dilated cardiomyopathy].

The efficacy and safety of different variants of left ventricular geometrical reconstruction (LVGR) in patients with dilated cardiomyopathy (DKMP) were studied in 2-stage clinical trial during 4 years. Results of left ventricle plication, "Myosplint" surgery and implantation of extracardial net framework (ECNF) complemented with mitral insufficiency correction (in case of need) have been evaluated on the first stage of the study. Based on this study, the implantation of ECNF and correction of mitral insufficiency are recognized as the most effective and safe method of DKMP surgical treatment. Short- and long-term results of these surgical procedures have been studied on the second stage of the study. Overall 30 surgeries of LVGR have been performed (18 on stage 1 and 12 on stage 2 of the study). Hospital lethality on stage 1 was 27%, 4-year actuarial survival rate (taking into account hospital lethality)--54+/-12%. Original protocols of surgical, anesthetic and intensive care management led to decrease of hospital lethality to 8% and an increase of 2-year actuarial survival rate to 91.6+/-7.9% (that significantly higher than in the control group treated with therapeutic methods only).

Cardiac Surgical Procedures↗
PubMed2006

[Echocardiography of operated heart. Assessment of results of mitral valvuloplasty].

AIM: To assess results of surgery and to elaborate criteria of noninvasive diagnosis of cardiac function in patients with rheumatic mitral disease after reconstructive interventions on mitral valve. MATERIAL: Patients (n=192, mean age 41.2+/-1.2 years) with pure mitral stenosis (76%) and combined mitral valve disease with prevalent stenosis (24%), and 32 practically healthy people (n=32, mean age 36.6+/-3.5 years, control group). METHODS: Comprised transthoracic mono and two-dimensional echocardiography and doppler echocardiography. Results of intracardiac flow study were compared with data of invasive methods of investigation--intraoperative flowmetry and manometry, cardiac catheterization and intraoperative transesophageal echocardiography. RESULTS AND CONCLUSIONS: The following criteria of hemodynamically effective valvuloplasty were established: lowering of mean mitral valve pressure gradient by 54-65%; absence of regurgitation or lowering of mitral valve regurgitation fraction to < or =6% of total stroke volume. Significant increase of left ventricular stroke volume (by 22-27%), increase of mitral valve area (by 164-222%), decrease of left atrial diameter (mean decrease 17%) were also noted.

Adult↗
PubMed1998

The significance of colour velocity and spectral Doppler ultrasound in the differentiation of liver tumours.

OBJECTIVE: The aim of the work was to develop a standard protocol of colour velocity and spectral Doppler ultrasound (D.-US) of liver tumour vascularization and to estimate the value of this method in differentiation of liver tumours. METHODS: In 1994 and 1995, 68 patients with 128 primary and secondary liver tumours were observed. The final diagnosis was histologically verified. The diagnostic system Acuson 128 X/P 10M (Mountain View, CA) with 3.5 MHz convex abdominal probe was used. Qualitative features (vessel presence, vessel location and waveform of tumour vessel blood flow) and quantitative features (vessel quantity per cm2, vessel diameter, maximum velocity (Vmax), and resistance index (RI) of tumour artery, and Vmax of tumour portal vein) were included in the D.-US protocol. The differences in these features among various liver tumours were retrospectively analysed. RESULTS: The tumour vascularization was found more frequently in hepatocellular carcinoma (HCC) than in cavernous hemagioma (CavHA) or metastatic liver lesion (MLL) (P<0. 01). Among the tumours with detected vascularization, significant differences (P<0.01) were found (1) in vessel presence: (a) around tumour between MLL and HCC with or without liver cirrhosis (LC) or CavHA; (b) in periphery of tumour between HCC,CavHA, benign tumour (BT; hepatocellular adenoma, focal nodular hyperplasia) and MLL; (2) in detection rate of arterial blood flow between HCC with or without LC and CavHA or MLL. The other differences were not statistically significant. CONCLUSIONS: According to our findings D.-US can be used for the differentiation of some liver tumours when using the criteria: (a) vessel presence around or in periphery of tumour, and (b) arterial flow pattern in tumour vessels.

Adolescent↗
PubMed1998

[Variations of cardiac cycle length in patients with coronary heart disease before and after aortic coronary bypass surgery].

It is well known that variations in cardiac cycle length or heart rates may be used for noninvasive evaluation of autonomic cardiovascular control. The investigation uses an original procedure. The data for analysis of cardiac cycle length variations (CCLV) are those obtained regularly at follow-up intervals, random 24-hour Holter 2-lead ECG recordings for 5 sec, and simultaneously calculated continuous sequence of mean heart rate. With the procedure, the correlations of CCLV with the parameters reflecting the early postoperative status of patients with CHD, including acute myocardial infarction, acute heart failure, rhythm and conduction disturbances, as well as age, operative stress, concurrent diseases. The findings are of both diagnostic and predictive value at subsequent stages of CHD treatment.

Coronary Artery Bypass↗
PubMed1998

[Estimation of vascular blood flow velocity in the breast neoplasms].

Based on examinations of 133 females having the normal breast, benign and malignant tumors, the potentialities of color Doppler mapping of breast vessels are shown. Cancers showed an increased vascularity in the peritumor areas and high flow velocity (Vmax' Vmean) in the surrounding tumor vessels. These criteria are not related to the size of a malignant tumor.

Adolescent↗
PubMed1997

[Surgical treatment of patients with chronic critical ischemia of legs, caused by atherosclerosis].

208 patients with primary chronic critical ischemia of lower extremities (CCILE) were operated on from 1988 to 1995. The criteria of CCILE were the following: ischemia of an extremity in rest with specific ischemic pain for more than 2 weeks; existence of ulcernecrotic changes in distal parts of the extremity; brachiommalleous index (BMI) less than 0.35; malleous systolic pressure less than 50 mm Hg. Functional condition of the patients corresponded to class 3A, B and 4. The share of patients with CCILE among patients with lower extremities arterial lesions was 35%. In 150 (72%) of them there were lesions of aorto-illo-femoral-tibio-popliteal segment; in 58 (28%)-damage of a femoral-popliteal-tibial segment. The number of patients with trophic changes appear in early stage. 154 reconstructive operations have been performed in patients with multiple arterial lesions higher and lower of the Poupart's ligament, and only one primary amputation and sympathectomy. In 63 (42%) of the patients the "two-floor" reconstruction has been performed. In 142 (92%) of the cases positive results have been achieved. In 78.5% cases the grafts were competent a year after the surgery and the extremities were saved in 88% of the patients. 60 reconstructive operations, 3 primary amputations and 1 sympathectomy have been performed in patients with the lesions, located lower than Poupart's ligament. In 58 (96%) of the patients positive results were achieved. One year after surgery the grafts patency was 63.5%, and extremities were saved in 79% of the patients. The immediate and long-term follow-up results of femoral-politeal and femoral-tibial grafting did not differ significantly. Long-term follow-up results were better in case of less duration of CCILE before surgery. Adequate revascularisation of the extremity is an optimal method of treatment of patients with CCILE.

Amputation, Surgical↗
PubMed1997

[Comparison of transesophageal and transthoracic echocardiography in cardiac surgical care].

This paper analyzes the results of 1093 transesophageal (TEE) and transthoracic echocardiographic (TTE) studies made in patients with various cardiovascular diseases in December 1989 to November 1996. The investigation was undertaken to define indications for TEE. Undoubtedly, TEE has some advantages over TTE in diagnosing abnormalities of the descending aorta, thromboses of the left atrium, small vegetations of cardiac valves, insignificant atrial septal defects and in evaluating excursions and systolic thickening of middle and basal segments of the left ventricular anterior wall. However, detection of thrombosis of the left ventricular apex remains to be priority in TTE. TEE was found to supplement TTE and considerably improves the diagnostic quality in cardiovascular diseases.

Echocardiography↗
PubMed1995

[Characteristics of interrelations of external respiration, gas exchange and hemodynamics in patients with bronchopulmonary diseases].

In 60 patients with stage II-III bronchogenic carcinoma of the lung the following procedures were included in the complex of preoperative functional examination: spiro-body-plethysmography, catheterization of the right heart, and simultaneous examination of gas exchange using a DELTATRAC MBM-100 metabolic monitor. To evaluate the lung diffusion capacity and the dimensions of the arteriovenous shunt, oxygen mixtures differing in O2 concentration were used. The results were interpreted within the framework of a homogeneous model of lung gas exchange realized on a PC/AT personal computer. The interrelationship of ventilation disorders with hemodynamic and lung gas--exchange function was studied. Arterial hypoxemia was mainly observed in obstructive and mixed disorders of ventilation function and was more marked in the latter. Primary disturbance of the lung diffusion capacity was found to be the leading link in the development of acute respiratory insufficiency after the operation.

Aged↗
PubMed1994

Long-term results of plastic reconstructions in acquired aortic valvular disease.

Plastic surgery in acquired aortic valvular disease was performed in 164 patients. Among them, 9 had the isolated aortic valvular injury; 130 mitral-aortic defects; and 25 three-valve injuries. The restoration of the injured valve function was achieved, as a rule, using a combination of surgical methods: commissurotomy or wedge resection of the fibrous tissue in the commissurial area; parietal resection; the aortic root frame plasty; perforation hole plasty; the allogenic valvuloaortic complex sector transplantation; and wedge resection or isometric cusp plication in the commissurial area. Calcinosis was not a contraindication to surgery, if it could be removed completely without the cusp closing function disturbances. The hospital mortality rate was 8%. After hospital treatment all the patients were followed-up: 108 for over 1 year, and the maximum term of the follow-up was 7 years. From 1 to 4 years postoperatively, 4 patients were reoperated due to the appearance of aortic insufficiency. The causes of relapse were: infectious endocarditis (3 patients); active rheumatic process (1 patient); and progressive dilatation of the fibrous ring (1 patient). During the follow-up 8 patients died: 6 of infectious endocarditis with mitral prosthetic injury; and in 2 the cause of death was not clear. The study of immediate and long-term aortic valvuloplasty results based on the clinical experience of 164 operations allows to recommend the elaborated principles of the aortic valve surgical reconstruction for a wide application in cardiac surgery.

Aortic Valve↗
PubMed1992

[Evaluation of right ventricular myocardial excursions in patients with mitral valve stenosis without pulmonary hypertension].

As many as 23 patients with mitral stenosis were examined intraoperatively, by evaluating of intracardiac hemodynamics and right ventricle myocardial excursions. Before mitral stenosis was corrected, 56% of patients had demonstrated myocardial excursion disorders. After the correction the number of patients with myocardial dysfunction halved. The transition of patients belonging to the group with abnormal myocardial excursions to the group with normal excursions depends on the scope of surgical intervention and pharmacological support. After the correction of mitral stenosis cardiogenic and pulmonogenic complications may mostly be seen in the patients' group showing abnormal myocardial excursions. It is concluded that the symptom of abnormal right ventricle myocardial excursions is of prognostic significance with respect to the development of complications in the early postoperative period.

Adult↗
PubMed1992

[Assessment of myocardial function and metabolism in patients during aortocoronary bypass surgery after hypoxia-reoxygenation].

The myocardial function and metabolism were assessed in 12 patients with coronary heart disease intraoperatively during aortocoronary bypass surgery. The antioxidative properties of the blood of the heart were found to become lower along with activated peroxidation after the major stage of an arrested heart operation, that correlated with depressed myocardial function.

Adult↗