NEW APPROACH TO THE TREATMENT OF VALVULAR INFECTIOUS ENDOCARDITIS

An. original method of intracardiac sanation of infection nidus with use of the preparation of bacterial proteinases immobilized on polymeric matrix was offered and proved on the resulta of surgical treatment of 226 patients with infectious endocarditis. The results of treatment were analysed and. the effectiveness of the method was proved

DIAGNOSIS AND TREATMENT OF CARDIAC MYXOMA

Cardiac tumors are extremely rare pathologies with polymorphic clinical presentation, mainly founded in autopsy, and accidentally in cardiac surgery. Primary tumors of the heart are detected in 0.002-0.05 cases of autopsies, and 75 % of the tumors are the benign ones. Cardiac myxoma is the most frequent tumor of the heart. It can be localized in any chamber, but more often occurs in the left atrium. A pedunculated myxomas prolapse into mitral orifice, obstructing outflow from left atrium and inflow to left ventricle in diastole. Microscopically myxomas can have slimy, rigid, lobed or loose structure. Myxomas with loose consistency are most dangerous in occurrence of systemic embolism. Also, tumors can locate in ventricle or in several heart chambers. Most of tumors has a peduncle, a fibrous-vascular stalk from 4 to 8 cm in diameter. In 93 % cases myxomas are the single chamber tumors, but they can be biatrial, and grow in several chambers of the heart, thus, are the multiple primary tumors. The symptoms are of widely varied character and depend on the size and localization of the tumor. Now, because of advances in diagnostic, the frequency of myxoma detection is annually increasing, counting from 0.5 to 2.3 cases per 1 million people. The group of 70 patients aged from 19 to 77 with morphologically confirmed myxomas was analyzed. Surgical intervention is the only way to treat myxoma. The case described in the article presents a large myxoma, almost completely filling left atrium with mitral orifice occlusion. Routine echocardiography facilitated a timely diagnosis, and required treatment was performed

THE RESULTS OF THE OFF-PUMP CORONARY ARTERY BYPASS OPERATIONS IN PATIENTS WITH CORONARY HEART DISEASE

The study of the nearest and remote results of off-pump coronary artery bypass. The nearest results are analyzed, in 2176 patients. Complications in the early postoperative period, were observed in 227 patients (10,4 %). Time of stay of patients after surgery in ICU was 21 (18—32) hour and in the hospital after surgery — 7,1 (5—9) days. 30-day mortality was 0,9 (0,5—1,3) %. Remote results of treatment were studied in 1146 patients (53 % of operated patients). Survival rate of patients during 9 years after surgery was 73 %. Freedom, from cardiovascular events during the same period was 64 %