[Remote results of surgical correction of heart septal defects].
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A defect of the interventricular septum (DIVS) in the perimembranous zone can be a source of reversible (hypertrophy) and irreversible (fibrous degeneration) alterations of the moderator band (MB), normally or abnormally located in the right ventricle of the heart. DIVS goes with changes of MB in 7,27% of the cases. Operations are necessary in combinations of DIVS with changes of MB. Surgical correction is indicated to patients with DIVS and the abnormal muscular band. Operative treatment should not be used for the compensatorily hypertrophic MB, located normally or abnormally.
A working scheme of indications for the surgical correction of defects of the interventricular septum (DIVS) has been developed on the basis of observation of 810 patients. An anatomo-topographic classification of DIVS on the basis of studying preparations of 109 hearts is proposed which is convenient for choosing a method of closing DIVS. The incidence of complications after operations under conditions of moderate hypothermia was shown to be not higher than after those performed under the artificial blood circulation.
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Various flow phenomena can occur in MR tomography of the heart. In the present study the influence of various examination parameters on the imaging of flow phenomena behind cardiac septum defects was investigated by means of a model. In the examination by fast field echo sequence (FFE) the contrast between poststenotic jet and surrounding area was most pronounced if short echo times (TE 10 ms), a narrow flip angle (d = 10 degrees) and layers of minor thickness (d = 5 mm) had been selected. The number of acquisitions and the flow compensation exercised only slight influence on contrast. Our results point to the possibility of obtaining quantitative information on cardiac septum defects if the influence of examination parameters on the imaging of flow phenomena is accurately known.
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