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[Repeated plastic operations on the abdominal aorta and main arteries of the pelvis and lower limbs in arteriosclerotic occlusion].

Among 600 patients operated on primarily for atherosclerotic lesions of the aorto-iliac-femoral zone (various plastic operations) secondary interventions were undertaken in 140 persons with re-occlusions of the operated segments. All patients were subjected to secondary reconstructive-plastic operations that gave good results--elimination of ischaemia and preservation of the extremity--in 77.2% of the cases. In 12.8% of them the extremity was amputated. Postoperative mortality comprised 10%.

Aorta, Abdominal↗

[Modern diagnostic approaches to investigations of abdominal aorta changes in flying personnel].

Modalities of the modern radiation diagnostics (USI and computer tomography) in expert investigation of the ventral aortas in pilots of different aircraft were demonstrated. The most effective diagnostic algorithm of investigation and determination of hypertrophy of the ventral aorta, and detection of the atherosclerotic plaques calcinosis has been developed and its importance for medical certification demonstrated. Morphostructural changes in the ventral aorta were featured and correlated with the debilitating occupational conditions in different types of aviation.

Adult↗

[Continuous inhalation administration of surfactant-BL for control of adult respiratory distress syndrome after reconstruction of the abdominal aorta].

A 62-year-old patient with Leriche's syndrome and critical ischemia of the low extremities has undergone the surgery of aortofemoral grafting. A patient has developed the severe ARDS on the second day of reperfusion (bilateral diffuse infiltrates, PO2/FiO2 < 100, lung injury score was 3). Different ways of administration of bovine surfactant (SURFACTANT BL, Russia) were used during the treatment. Total application time was 84 hours, total dose was 4000 mg (50 mg/kg). Considerable improvement of lung function occurred after start of the continuous inhalation of surfactant with a constant rate of 63 mg/h. Two hours after this step PO2/FiO2 reached 400 mm Hg and remained stable 12 hours more, up to the end of surfactant administration. The patient was soon successfully extubated and discharged on the 25th day after surgery. It is supposed that in spite of a small total dose of bovine surfactant the success was achieved due to an early start of the surfactant replacement, continuous inhalation and its definite rate.

Administration, Inhalation↗

[Ruptured aneurysms of the sub-renal abdominal aorta].

The rupture of an aneurysm of the sub-renal aorta may give rise to several clinical presentations which it is essential to recognise in order to carry out emergency operation, e.g. attack of pain, retroperitoneal hematoma, hemoperitoneum, rupture into a hollow viscus, infective aneurysm. The special characteristics of the treatment concern resuscitation, site and type of aortic clamping, aorto-caval or aorto-digestive rupture or an infective aneurysm raising special problems. It is the vascular collapse which makes the rupture serious, an aneurysm operated as an emergency without collapse, has a mortality which differs little from a non-ruptured aneurysm, e.g. 3 deaths out of 55 operated cases. On the other hand, out of 44 aneurysms operated in acute collapse, there were 31 deaths. The complications observed are linked to the latter, e.g. cerebro-vascular accidents, acute coronary ischemia, acute ishemia of the limbs, which may also be due to embolism during operation, renal complications due to renal shock. The prevention of these complications has permitted us to reduce mortality by 40 p. 100 the last 5 years.

Adenoma↗