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Biomedical subjects

V I Burakovskiĭ

Publications and source records attributed to V I Burakovskiĭ.

At least 19 recordsLinked to original sources
PubMed1992

[Active valvular infective endocarditis: problems of surgical treatment].

The authors analyze the results of surgical treatment of patients suffering from active endocarditis with impairment of the mitral, aortal and tricuspid valves and their combinations in 242 patients operated on during 1969 to 1989. The total hospital mortality is at the level of world statistics and constitutes 15.3% (37 patients died). The main cause of the hospital mortality was acute progressive heart failure (48.6%). The long-term results of the surgery were examined in 202 patients. By the 5th observation year the total survival was 73.2%, the stability of good results 83.6%. The defined grades of the activity of infectious process play an important role in the diagnosis and treatment of patients with active valvular infectious endocarditis.

Adolescent↗
PubMed1991

[Experience with a prosthesis of the pulmonary artery trunk at the A.N. Bakulev Institute of Cardiovascular Surgery, Academy of Medical Sciences, USSR].

From April 1975 to March 1991 sixty-four operations were carried out on 61 patients with various congenital heart diseases attended by impaired anatomical connection between the right ventricle and the pulmonary arteries. The patients' ages ranged from 9 months to 28 years (8 years on average). The most frequent clinical diagnoses were total transposition of the great vessels with ventricular septal defect and stenosis of the pulmonary artery (26 cases), type I common arterial trunk (14), Fallot's tetralogy (11 cases). Origin of the aorta and pulmonary artery from the right ventricle with stenosis of the pulmonary artery was encountered in 5 cases, origin of the aorta and pulmonary artery from the left ventricle with stenosis of the pulmonary artery in 4, and type II atresia of the pulmonary artery in one case. Three patients were reoperated on (reimplantation of an artificial pulmonary trunk). Synthetic prostheses with a biological (xenoaortic) valve made at the Institute, Bjerk-Sheily (USA) and Tascon Medical Technology (USA) "conduits", and synthetic prostheses devoid of valves were used. A "fresh" aortic alloprosthesis was used in one case. A statistically significant tendency towards reduction of operative mortality has been recorded (the mortality rate for the last 5 years is 14%). The late-term postoperative results were studied in 30 patients in follow-up periods of 12 months to 14.5 years (5 years and 5 months on average). Analysis of the late-term results shows the method to be highly effective. Stenosis of the prosthesis is the most significant problem of the late-term period.

Adolescent↗
PubMed1991

[The necessity for a differentiated approach to the treatment of acute disorders of the coronary circulation].

The article discusses problems of the tactics of treatment of acute disorders of coronary circulation with the use of radiologically-guided intravascular and surgical methods along with drug therapy. The authors conclude on the basis of accumulated experience that in most patients, both in unstable angina pectoris and in acute myocardial infarction, there is no need for emergency procedures and operations for direct revascularization of the myocardium, which should be resorted to only in patients with complete irresponsiveness to drug therapy. After stabilization of the condition, however, the tactics of diagnostic and therapeutic measures must be differentiated according to the patients' clinical condition and a series of laboratory indices. In particular, treatment should be limited to drugs in patients with an uneventful clinical course and high tolerance to physical exertion (bicycle ergometry test). Patients who are relatively irresponsive to drug therapy or have a low tolerance to physical exercises should be subjected to planned selective coronarography and, if indicated, treated by transluminal angioplasty of the coronary arteries or by an operation for direct revascularization of the myocardium. The authors emphasize in particular that the methods of drug, radiologically-guided intravascular, and surgical treatment should not be regarded as alternatives but as methods mutually complementing one another in different stages of the disease.

Angina, Unstable↗
PubMed1990

[Pulmonary hypertension in surgery of ventricular septal defects].

The article discusses the appraisal of the degree of pulmonary hypertension and surgery of a ventricular septal defect with pulmonary hypertension in 108 patients whose ages ranged from 8 months to 31 years. The hemodynamic and morphological manifestations of pulmonary hypertension were found to increase with age. The hemodynamic manifestations of the anomaly may be similar in different types of changes of the vascular wall. A sharply hypertrophied middle muscular coat may be the cause of residual high pressure after closure of the defect, but with gradual reduction in contrast to the stable increase in sclerosis of the vascular lumen. This predetermines lung biopsy as an obligatory method for verifying the severity of pulmonary hypertension, which together with the hemodynamic data allows the indications for closure of the ventricular septal defect to be determined.

Adolescent↗
PubMed1990

[Origin of the aorta and pulmonary artery from the right ventricle].

In the period of 1980 to February 1988, 60 patients aged 1 year 7 months to 23.5 years were operated on for concordant atrioventricular linkage and origin of the aorta and pulmonary artery from the right ventricle. Sixty-two heart specimens were examined to study the defect anatomy. The left ventricular outlet opened up in the subaortic cone (Type A defect) in 47 (78.3%) patients, in the common subaortic and subpulmonary cone (Type B) in 8 (13.4%) patients, in the subpulmonary cone (Type C) in 3 (5%) patients; 2 (3.3%) subjects exhibited nonconcomitant ventricular septal defect (Type D). Thirty-four (56%) patients had pulmonary stenosis. Concomitant heart diseases were found in 78%. Fifteen patients (25%) underwent radical operation after prior palliative interventions. The total fatal cases were 13.7% (out of 58 operated patients, 8 died) in the group of radically operated patients. The fatal outcomes were observed in Type A defect. The analysis showed that defect correction techniques, age, prior palliative interventions, presence or absence of pulmonary stenosis, concurrent heart diseases, and restrictive ventricular septal defect failed to affect the immediate result of surgeries. An inaccurate preoperative diagnosis and lack of surgical experiment were factors increasing the risk for correction from 1980 to 1986. In the 2 years, the death rates decreased from 17.9% (7 dead patients per 39 operated ones) to 5.3% (1 dead patient per 19 radically operated ones).

Abnormalities, Multiple↗
PubMed1989

[Acute disorders of the blood circulation and cardiac insufficiency following open heart surgery].

General theoretical aspects (classification of circulatory disorders and heart failure) and results of research into specific subdivisions of cardiovascular and respiratory system pathology in cardiac surgical patients are discussed. The material is aggregated by the applied clinico-mathematical approach that has been developed and introduced into clinical practice in the recent 15 years at the Bakulev Institute of Cardiovascular Surgery. The extension of the clinico-mathematical approach onto the intraoperative control and analysis of the patients' status, assessment of the anaesthetic administration and cardioplegic protection is first overviewed.

Acute Disease↗