Prosthetic cardiac valve, method of prosthetic cardiac valve testing for dysfunction and related device for implementation thereof
FIELD: medicine; cardiology.
SUBSTANCE: said valve comprises a ring box and a number of indented leaves to be attached thereto. The ring box is supplied with an opened conductive element arranged therein or on its surface. Fastening indents for each leaf are interconnected in pairs with the conductive element contacting to the conductive element of the ring box. The method involves fitting the valve with a radiator and recording electromagnetic radiation within radio frequency band therefrom, as well as determining the dysfunction by frequency response deviation from the reference received from a standard valve. The device for valve testing for dysfunction comprises a receiving antenna representing a multi-turn spiral arranged on the external surface of the patient's body at the minimum distance between the valve and the antenna connected to a recording unit.
EFFECT: possibility to examine dysfunction of the valve in service.
3 cl, 1 dwg
The invention relates to medical equipment, namely to artificial prostheses for the circulatory system.
Known cardiac valve prosthesis containing a cylindrical housing with the tabs on the inner side of the housing, and limiting locations of the leaf (locking element) in the cross-section of the valve, ensures retention of the leaf and the overlap of the locking element bore holes in the housing (US 6569197 ). A disadvantage of the known device is the displacement of the locking element relative to the Central axis of the housing, which leads to deterioration of overlapping bore holes and reduce the performance of the locking element from the specified offset.
Also known artificial heart valve, containing a cylindrical housing in which two symmetrically located sash mounted on axes that are installed on the diameter of the shell (see "Actual problems of surgery. M., 1977, p.46-48 ). A disadvantage of the known valve is the occurrence of impaired venous return and discusses ways to reduce this instability. In addition, the leaflets of the valve is fixed with arbitrary gap on the axes of the body, which can lead to increased damage of the blood particles and cause difficulty in turning the leaves.
Closest to the claimed artificial valve in its the clinical entity is an artificial heart valve, containing a circular casing with leaves, the base of which is pivoted on the outer ends of the valve body by four speakers mounting the arms and have the ability to disperse when opening the valve in different directions with the formation of a Central access hole (EN 2300347 ). A disadvantage of the known valve is a high mechanical noise generated by the collision of the valves of the case when opened and closed, resulting in the disruption of moving parts. The wear elements occurs due to imbalance of the valves relative to their center of mass, which leads to a rapid increase of the gap between the fastening elements of the valves and the subsequent prednaznacheniyu (due to abrasion of the material and the formation of microcracks in the material of the sash and casing. Another disadvantage of the known valve is the lack of control upon the occurrence of pre-fracturing of the material and the exclusion of predicting the health of a valve for a long period of time.
In recent years bivalve mechanical prosthetic heart valves, characterized by laminar blood flow and hemodynamic performance, superior to those of the mechanical valves and other structures, is not always possible to avoid specific cleansability complications.
Patie what you bivalve mechanical artificial heart valves (X) deserve special attention, since the signs of the dysfunction can they develop suddenly, very quickly lead to uncontrolled heart failure and death.
Known (Zuckerman GI, Malashenko A.I., I. Skopin and other Results of surgical treatment of patients with mechanical obstruction of prosthetic heart valves. Thoracic and cardiovascular surgery, 200, No. 2, p.4-9. ) the following options dysfunctions bivalve X:
mechanical dysfunction (wear and fault locking element, the gap between the spikes of the prosthesis);
- fistula of the prosthesis;
- pannus prosthesis.
High diagnostic technologies, among which the ultrasonic methods are Central, caused undoubted successes in the diagnosis of dysfunctions of bivalve X. It has become possible to estimate the size of the cavities of the heart, the indices of contractility of the ventricles in the dynamics, register gradients at the level of the valve, to estimate the effective area of the valve hole.
But using transthoracic ultrasound cannot achieve a perfect diagnostic effect.
Mechanical prosthetic heart valves give expressed acoustic shadow, so when transthoracic echocardiography (TAHONG) it is impossible to assess the state of oral fibrillation, the confluence of pulmonary and small veins, Park appannie structure; and when prosthetic aortic valve in the rear wall of the aorta. In addition, the sensitivity of color Doppler mapping when transthoracic study is not sufficient to accurately assess the severity of paracetanol regurgitation (Abdullaev RA, Sable US and other Modern echocardiography. Kharkov: fortune press, 1998  and Schiller NB, Osipov, M.A. Clinical echocardiography. M., 1999 ).
Closest to the claimed method for the diagnosis of dysfunction mechanical butterfly valves of the heart is the method known from RU 2272571 . The method includes clinical and ultrasound examination. After performing transthoracic echocardiography performed transesophageal echocardiography to assess the function of bivalve mechanical artificial heart valve by movement of locking element, the presence of additional signals in the projection of the prosthesis, the pressure gradient at the level of the valve and the effective area of the prosthesis, hemodynamic characteristics paraproteins regurgitation determine the severity of paraproteins mitral regurgitation as insignificant when spread reverse jet of I-II degrees to the medial third of the left atrium, the width of the jet more than 0.3 and less than 0.6 cm, the area of the jet to the area of the left atrial less than 20% of the area of the left atrium, as a moderate in the propagation of the reverse jet II-III degrees to the upper third of the left atrium, the width of the jet more than 0.6 and less than 0.8 cm, the area of the jet to the area of the left atrium from 20% to 30% of the area of the left atrium, as expressed in the propagation of the reverse jet III degree, the width of the jet more than 0.8 and-1.0 cm, the area of the jet to the area of the left atrium more than 30% to 40% of the area of the left atrium, determine the severity of paraproteins aortic regurgitation as insignificant when spread reverse jet I or I-II degree up to the front door of the mitral valve, the width of the jet than 0.5 cm, the ratio of the jet of regurgitation to the diameter of the outlet of the left ventricle (VOLI) more than 1/3 of VOLE as reasonable in the propagation of the reverse jet II-III degree to heads of papillary muscles of the mitral valve, the width of the jet more than 0.5 and less than 0.7 cm, the ratio of the jet of regurgitation to the diameter of VOLI more than 1/3 and 2/3 from VOLZ, as expressed in the propagation of the reverse jet III-IV degree to the apex of the left ventricle, the width of the jet more than 0.7 cm and the ratio of the jet of regurgitation to the diameter of VOLI more than 2/3 of VALI.
The disadvantage of this method is its high complexity of implementation associated with the necessity of introducing into the body of the patient foreign bodies, as well as the relatively low accuracy of the op is adelene condition of individual elements, included in the design of the valve, and such phenomena as, for example, incipient cracks, material fatigue, which can serve as a harbinger of destruction.
Analysis of the prior art showed that the proposed design of the IRS and related design features of the method of determining its dysfunction there are no known devices that would allow to register changes in the body material and the valves of the valve implanted in the patient's body.
Claimed as the invention of the artificial heart valve (D)method of determining its dysfunction and device for implementing the method of determining the dysfunction is aimed at monitoring the performance of the heart valve when prefracture material of the valves, casing and preventing accidental operation of the valve.
To achieve the specified result, you must create a new design heart valve, which will allow to monitor its health. While this design should be capable of determining its dysfunctions and timely measures to eliminate them. Accordingly a method of determining the dysfunction of the proposed design of artificial heart valve, and means on the determining.
This result is achieved in that an artificial heart valve includes an annular body and a few valves with flanges for mounting on it, with a circular casing provided with an open ended conductive element placed inside or on its surface, and protrusions for attaching each leaf is connected in pairs between a conductive element in contact with the conductive element of the ring body.
For effective removal of the electromagnetic signal fold X is made from a conductive rod mounted in the direction of the longitudinal axis in the center of the protrusions, and the stem of each leaf has a mechanical and electrical contact with the conductive elements of the protrusions of the support ring (see drawing).
This result is achieved in that the method for determining dysfunction artificial heart valve includes a supply valve emitter and registration of electromagnetic radiation in the radio from him and the determination of the presence of dysfunction on the deviation of the amplitude-frequency characteristics of a reference received from the exemplary valve.
This result is achieved in that the means for determining dysfunction artificial heart valve includes a receiving antenna, made in the form of a multiturn spiral that is hosted on external surfaces is t the patient's body with minimal distance between the valve and the antenna, connected to the recording unit.
The implementation of the annular valve body with a conductive open-circuited element placed inside or on its surface, so that the tabs for attachment of each leaf were connected in pairs between a conductive element in contact with the conductive element of the ring body, allowing you to record electromagnetic radiation in the radio band, formed as a result of microcracks that occur in the material of the ring body and the valves during operation of the valve. Upon the occurrence of microcracks on the surface of the material of the ring body and wings or inside it produces electromagnetic radiation in the radio band, which leads to conductive elements variable signals that can be registered with the receiving antenna located on the surface of the patient's body.
At the time of formation of microcracks is the destruction of intermolecular bonds, the change of the dipole moment, the vibrations of the crystal lattice (in the case of conductive material of the ring body), which leads to an alternating electric and magnetic fields, which may be registered antenna reception. As determined experimentally, the emission spectrum of the electromagnetic field depends on the value of Tr is women material of the ring body and wings. In the case of formation of one or more of microcracks in the spectrum of the radiation components appear responsible for prednaznachenie material. The magnitude of the signal depends on the speed of propagation of microcracks, the type of material and the number of microcracks per unit volume.
The conductive elements on the annular body and the wings need to perform open, as in a closed conductive element signal decreases due to a short circuit in the system transmitting antenna is the source of education specified signal", i.e. in the "transmit antenna - crack". In this case, the role of the transmitting antenna will perform open-loop conductive elements of the body and wings. When forming the electromagnetic signal in a short-circuited site of the transmitting antenna, the impedance of this element is almost zero, while in the "antenna - input Registrar" resistance is finite, therefore the amplitude of the electromagnetic signal is less than the input resistance of the Registrar due to a short circuit in the conductive element of the transmitting antenna. From these considerations conductive areas of the transmitting antenna of the ring body and wings are made open, which increases the efficiency of reception of a signal during micrometres the deposits.
Execution conductive element over the entire surface (external and, in some cases, the inner ring body allows us to "cover" all areas of controlled material and to bring the antenna to the radiation source of the electromagnetic signal, which also increases the efficiency of control arising prefracture material of the ring body and wings.
As for the tabs, which are pairwise interconnected electrically conductive elements in contact with the conductive elements of the ring body, it should be noted that the leaf X is technologically designed as a single unit together with the tabs. The conductive element of each leaf passes through its axis of rotation to the location within the material, for example made in the form of a metal rod of a given diameter and length, which electrically contact with the conductive element of the ring body (see drawing). In this case, the transmitting antenna conductive elements of the ring body and wings) covers the entire volume of the material of the ring body and wings. For example, when the occurrence of cracks in the shutter of the electromagnetic signal is generated in the metal rod, which is electrically connected to the conductive element of the ring body, with subsequent transfer of the signal at the receiving antenna, RAS is than necessary on the outer surface of the patient's body. Receiving antenna can be made multiturn to increase sensitivity to weak signals that occur when the microcracks short-haul (from microns to fractions of a micron).
The proposed artificial heart valve operates as follows. When the contraction of the heart muscle directional blood flow opens the leaflets of the valve, which rotates relative to the axis of rotation at a given angle limiters ICS. At the time of disclosure of the valves occurs the collision of the valves with a circular body. In this case, it may be two modes of operation of the valve. If the collision does not occur, the formation of micro-cracks (microcracks), the Registrar records the background signal, which is formed due to the formation of alternating potential due to the collision of the valves on the limiters of the ring body. The time of the collision much more time of formation of microcracks in the emission spectrum, which can be recorded by the Registrar (for this part of the recording device it is advisable to include a spectrometer), in this case, there is no discrete component of the signal, are responsible for the occurrence of pre-failure.
In case of formation of microcracks spectrum of electromagnetic radiation changes and shifts to high frequency range. For example, the R, if the length of the microcracks in 1 μm and speed 1 m/s emission frequency is 1 MHz.
At closing of the valves is their impact with the annular body. The presence of a background signal of high-frequency components says about the appearance of microfractures in the folds or the annular body. The number of registered pulses, occurring at the micro destructions, allows you to assess the effectiveness of the IRS and to prevent possible destruction of the valve elements.
In order clearly to determine the presence of microcracks or prefracture elements of the valve subjected to testing, you must first obtain the spectral characteristic of the reference valve, i.e. a known good and still not subjected to any loads. Then to assess the performance of the valve and its dysfunction for a certain period of time compare the spectral characteristics of the test and sample valves.
The essence of the claimed group of inventions is illustrated by the example of the drawing, which shows a General view of the X-men in two projections (top view and cross section).
X contains a circular casing 1, which is provided with the conductive element 2, covering the whole body from the outside (as shown in the drawing) or inside (not shown). Specified conductive ele is UNT made open-circuited, i.e. between its separate parts are gaps 3. On the casing protrusions 4 for fixing them wings 5. Sash equipped with axis 6, which is made of conductive material and their ends are in contact with the conductive element 2.
A device for determining dysfunction ICS (not shown) contains a receiving antenna, which can be made multiturn coil, such as coil or rod with a wound on it the wire or in the form of a flat spiral. The ends of the wires connected to the logger. The composition of the registration tool may include the amplifier an electrical signal, which can be selected from among known, and the output of the amplifier is connected directly to a recording device, which can also be selected from among known. For example, as the Registrar may be used recorder, a storage oscilloscope type C8-13, computer with software that allows the selection signal spectrum. Since the proposed device consists of only three parts (antenna, amplifier, recorder), each of which is widely known, and the connection between them does not require special knowledge, the view of the drawing, to illustrate, we find it unnecessary.
The claimed group invented the th is used as follows. The valve shown in the drawing, is implanted into the patient. Before implantation, it is necessary to obtain the reference spectrogram on the basis of which to judge the processes occurring in the valve, and to assess its performance, and the need for replacement. The reference spectrogram can be obtained in two ways. In the first case the valve is subjected to preliminary tests on the stand, which removed its spectral characteristics obtained from the Registrar when modeling at the stand of the valve under conditions that mimic the real. In the second case, after implantation of the recorded spectral characteristics of the operating valve. Given that between the time of implantation and removal of these characteristics runs small time interval, these characteristics can be considered as a reference. The valve works in the following way. Under the influence of contraction of the cardiac muscle blood flows through the valve pulsating flow and under the influence of the leaf 5 are opened and closed. When this flap hit the ring body 1. As a result of this collision occurs electromagnetic radiation, which, by means of conductive elements, the role of the transmitting antenna, is transmitted to the receiving antenna. The signal from the receiving antenna is transmitted through Wuxi is Italy to the Registrar and recorded in the form of a spectrogram. The resulting spectrogram is compared with a reference, i.e. removed the stand and immediately after implantation X patient. In the case of the spectrograms of the peaks that were absent on the spectrograms taken at the stand or immediately after implantation of the valve, it is possible to conclude that the structural elements of the valve appeared microfractures. Estimating the amplitude and frequency of the additional signal can be judged on the performance of the valve at the moment the patient.
1. Artificial heart valve, containing a circular casing, and a few valves with flanges for mounting thereon, characterized in that the annular body provided with an open ended conductive element placed inside or on its surface, and protrusions for attaching each leaf is connected in pairs between a conductive element in contact with the conductive element of the ring body.
2. The method of determining dysfunction artificial heart valve, which consists in the fact that as a radiator of electromagnetic signal using a working artificial heart valve according to claim 1, record the received electromagnetic radiation in the radio band, and the presence of dysfunction of the valve set on the deviation of the amplitude-frequency characteristics of a reference received from the exemplary clap the A.
3. A device for determining dysfunction artificial heart valve, comprising the emitter and the receiving antenna, made in the form of a multiturn spiral, placed on the external body surface of the patient's ability to comply with the minimum distance between the valve and the antenna connected to the recording unit, while the emitter is a working artificial heart valve according to claim 1.
FIELD: medicine; cardiosurgery.
SUBSTANCE: fragments aorta and pulmonary artery together with a valve unit are isolated from donor heart in sterile conditions. Then isolated homografts are estimated for adaptability. The fragments of aorta and pulmonary artery together with the valve unit are isolated in a sequence as follows: aorta and pulmonary artery are divided to fibrous rings of aortic and pulmonary valves; it is followed with excision of distal parts of pulmonary artery 2 cm away from artery mouths; left and right coronary arteries are isolated from epicardium and cut off 0.7-1 cm away from mouths; right ventricle of heart and interventricular septum are cut off 2-2.5 cm away from pulmonary valve in parallel to coronary transverse from heart edge to interventricular septum; then pulmonary homograft with muscular flange 2-2.5 cm of right ventricle of heart is isolated from fibrous ring, while aortic homograft with a flange 1.5-2 cm is isolated from fibrous ring of valve, herewith mitral valve anterior leaflet is left without chords to be cut off with shortening muscular flanges of transplants up to 0.5 cm in width and thickness. To test the valve unit for adequacy, homografts are turned inside out to make a visual inspection of valves, sinuses and vascular walls.
EFFECT: method allows standardising tissue preparation for transplantation, reducing number of damages of valve unit, isolated homografts, decreasing defect ratio and reduction cost price of commercial homografts, improving functional reliability of a transplant due to removal of models with border changes of valve tissues observed.
FIELD: medicine; cardiovascular surgery.
SUBSTANCE: heart valve bioprosthesis comprises a flexible bearing frame formed by three axially symmetrical arches joining the rack tops. The commissure tops are formed by shutters connected by sutures and fixed on the bearing frame enclosed in a biocompatible material, e.g. xenopericardium. The enclosure shaped as the top edge frame, while its bottom part is shaped as an edge of fibrous ring of recipient aortic valve and forms an attached cuff. A bioprosthesis is made of valve complexes of mammal hearts or pericardium.
EFFECT: inventions prevent stenotic effect and allow reducing operation time.
2 cl, 3 dwg
FIELD: medicine; cardiovascular surgery.
SUBSTANCE: valve contains a frame with a carrier ring corresponding with the natural shape of fibrous ring of human valve, a rack and an obturative shutter element attached to the frame. The carrier ring of the frame is segmented on perimetre, while the rack supports are V-shaped and interfaced to the ends of the specified segments of the carrier ring. The racks are provided with platforms to fix the tips of papillary muscles. The method consists that the carrier ring is segmented by number of racks. And the racks rest on the V-shaped bottoms to connect to the related segments of the carrier ring. The racks are supplied with platforms to fasten papillary muscles. The fibrous ring is fixed to the carrier ring of the frame all around, and the tips of papillary muscles are additionally reinforced with a biocompatible flap and fastened to rack platforms. The biocompatible material is used to make an attached cuff sutured to fibrous ring.
EFFECT: inventions allow for deformation of fibrous ring within heart cycle in conformity with deformations of fibrous ring of the recipient.
5 cl, 10 dwg, 1 tbl
SUBSTANCE: invention concerns medical equipment and can be used in cardiosurgery for replacement of the damaged natural valves of the heart. The prosthesis contains a ring-shaped case and rotary cusps. The agent of deduction of the cusp in the case is executed in the form of two pairs through grooves forming among themselves two mutually-grasping structures. One pair of grooves is executed on the opposite additional regiments located on an internal surface of the case. The second pair of grooves - on opposite parallel sites of a lateral surface of a cusp. The wall of each groove represents a part of surface circular ring from its internal diameter. On the case surface opposite face prominences are placed. Internal surfaces of these prominences are executed flat and mutually parallel, with the possibility of interaction with opposite parallel sites of a lateral surface of a cusp. The supports for restriction of an angle of opening of cusps are located on internal surfaces of face.
EFFECT: invention is referred on rising of reliability of the valve at the expense of clottage depression on hinges.
3 cl, 7 dwg
SUBSTANCE: invention concerns medical equipment, and can be used for replacement of the damaged natural valves of human heart. The skeleton contains a rigid tubular loose leaf with a ring-shaped basis. The flexible element having flexible legs, bridged to its bases is established on the rigid tubular insert. The rigid tubular insert is supplied departing from circinate base in a direction of an axis of the rigid tubular loose leaf by movement terminators. Each flexible leg contains two flexible beams executed with the possibility of a flexure independent from each other. Flexible beams are supplied by the basic racks bridged to the bases by intersections. Each terminator of movement of flexible legs is executed in the form of two rigid teeth, each of which are supplied by basic surfaces, thus rigid teeth are located on perimeter of the tubular loose leaf with interaction possibility the basic surfaces with basic racks of flexible beams.
EFFECT: invention provides dampening of shock load at valve closing.
2 cl, 3 dwg
SUBSTANCE: invention concerns medical equipment and can be used in cardiosurgery for replacement of the damaged natural valves of human heart. The prosthesis contains the ring-shaped case 1 on which external perimetre one prominence locking an element is executed, limiting return current of blood, and a cuff executed from a tissue and having a landing surface, contacting to warm tissues, and the external surface contacting to a stream of blood. The cuff is supplied by a skeleton forming an aperture for placing of the ring-shaped case of a prosthesis, a basic element and the lock element, fixing a prominence on the ring-shaped prosthesis case in a cuff skeleton, forming quick disconnect bond of the case with a cuff.
EFFECT: invention variants differ agents of bracing of a cuff.
7 cl, 4 dwg
FIELD: medicine; cardiosurgery.
SUBSTANCE: cardiac valve prosthesis contains rigid circular enclosure, obturative element installed within enclosure clearance, obturative element and enclosure junction and supraannular sewed-on cuff. Furthermore it accommodates subannular sewed-on cuff of radial dimension smaller than that of supraannular cuffs. The first stage involves that fixing suturing threads are delivered through subannular cuff of the prosthesis or behind the ventricular edge of tissue coating of the prosthesis enclosure containing one sewed-on cuff, or through the basement of the prosthesis sewed-on cuff containing one sewed-on cuff. The second stage implies through tissue fibrous ring of the natural cardiac valve from its ventricular surface, while for the third stage through the prosthesis supraannular cuff or through sewed-on cuff closer to its free edge for the prosthesis containing one sewed-on cuff.
EFFECT: reduced or eliminated prosthesis-patient inadequacy after cardiac valve prosthetics.
16 cl, 16 dwg, 1 ex
FIELD: medical equipment.
SUBSTANCE: test unit is applied for characterisation of prosthetic cardiac valve for replacement of affected natural cardiac valves. Test unit contains canal connecting vessel with hydropneumatic accumulator. Chamber containing analysed valve is mounted in canal. Lower end of gauge tube is connected to outlet chamber canal, and its upper end to hydropneumatic accumulator. Locking element opens or closes canal outlet to hydropneumatic accumulator. Pneumatic actuator assembly with heart rate controller is connected to hydropneumatic accumulator and provides required pressure. Hydropneumatic accumulator is attached to vessel or measuring tank through drain cup with float and back pressure valves and distribution valve. Vessel, gauge tube and measuring tank are provided with appropriate level indicators. If locking element is open and hydropneumatic accumulator is connected to measuring tank with distribution valve, analysed valve capacity is measured. If locking element is closed and hydropneumatic accumulator is connected to vessel with distribution valve, return crossflow of analysed valve if measured.
EFFECT: invention provides approximation of valve test conditions close to living organism environment.
7 cl, 4 dwg
FIELD: medicine; vascular surgery .
SUBSTANCE: prosthesis of venous valve represents a tube made of polymer. The prosthesis includes a cylindrical part serving for fastening a prosthesis of venous valve in a vein, a flexible pencil-point transition of decreasing diameter closed and passing to the locking device, formed from a part of the tube with reduced diameter in the form of a tape closed along the perimeter, flat, form-stable, elastically deformed and combined in three, or more, radial bond.
EFFECT: invention improves basic characteristics of a venous valve prosthesis and essentially reduces a retrograde stream.
3 cl, 1 tbl, 6 dwg
SUBSTANCE: invention relates sphere of medical technique and can be used in cardiosurgery. Prosthesis contains frame with two beads and blocking element as three similar convexoconcave cusps. Frame inner surface in its upper part is created with three pairs of cylindrical intersecting surfaces of the same diameter. Geometric axes of these cylindrical surfaces are dislocated from the geometric axis of the external surface on the distance equal to 1/8-1/4 of external cylindrical surface diameter. Cylindrical surface in every pair are turned one to another around the external surface axis on the angle of 18-40°. Pairs of cylindrical surfaces are turned one concerning another on 120°. In places of cylindrical surfaces intersection on the frame are created the six ledges of two different sizes. On the inner side of the body frame three ledges of one size take turns next to one with three ledges of another size. In ledges of more size semispheric deepings are made complying the semispheric ledges of cusps. Ledges of less size define the position of peripheral edge of every closing element cusps in close position.
EFFECT: reliability increasing of cardiac valve.
2 cl, 6 dwg
SUBSTANCE: according to the method, contact members of a transmitting and receiving transducer are pressed to surface of analysed biological tissues at the same pressure force. Mechanical vibration of acoustic wave range is excited on surface of analysed tissue; delay time of the sensed signal is measured concerning the radiated one. The measurements are performed at a number of acoustic frequencies using a harmonic signal of constant frequency and amplitude for each measurement. Each measurement is preceded with instrument calibration to evaluate natural frequencies of the instrument elements to be excluded from those used in measuring. The induced noise signals are compensated. The pressure force is of the converters specified so that to provide the least penetration depth of acoustic waves into analysed biological tissue. Then measurements are performed at a number of frequencies with amplitude of the received signal are extreme.
EFFECT: higher reliability of measurements.
SUBSTANCE: invention relates to field of medicine, namely to vascular surgery. Preliminarily computer or magnetic-resonance tomography of skeletal muscles of lower limb (limbs) is performed. Density of muscular tissues of posterior group of shin muscles is determined, formation of distal arterial-venous fistula is realised immediately after finishing reconstruction of main arterial channel with density of muscular tissue of posterior group of shin muscles equal or less than 40 HU, by data of computer tomography, or ratio signal/noise, equal or more than 10 specific units, by data of magnetic-resonance tomography, performed on apparatus Magnetom vision with magnetic field intensity 1.5 Tesla.
EFFECT: extension of arsenal of means for determining adequate tactics of treatment of obliterating atherosclerosis of lower limbs vessels.
4 dwg, 2 ex, 1 tbl
SUBSTANCE: intra-operation transesophageal echocardiography is performed. Additionally morphometry is performed after cardioplegia and cardiotomy, anatomical valve structures are measured and estimated: intercommisural distance, length of chords, state of chords, mobility of cusps and state of chords are evaluated in points: 0 points - thickening and/or shortening of chords, 1 point - normal state of valve chord apparatus, 2 points - elongation of supporting chords, 3 points - avulsion from papillary muscle or chord rupture; mobility of cusps is also evaluated in points: 0 points - mobility is limited because of rigidity of cusp and/or chord apparatus, 1 point - normal mobility, 2 points - mobility of cusp (cusps) is heightened, there is prolapse into left auricle not less than 7 mm deep, 3 points - cusp (cusps) freely turn out into auricle cavity. In case if said point sum does not exceed 1, valve replacement is indicated, if point sum is equal 2, isolated annuloplasty is indicated. If sum of points is within the range 4-6 resection of cusp segment is performed, in all other cases shortening or prosthetics of chords is indicated; annuloplasty method is chosen on the basis of intercommissural distance evaluation, in case if distance between commissures does not exceed 31 mm, suture annuloplasty or flexible semi-rings are used, if dimension of commissural space exceeds 31 mm, annuloplasty on rigid supporting ring is used.
EFFECT: increase of accuracy in choosing method of mitral valvular disease correction.
SUBSTANCE: invention relates to field of medicine, namely, to urology. Laser Doppler ultrasonography, in which probe-sensor is installed in point of prostate gland projection perpendicular to perineum skin. Dopplerogram is decomposed into harmonic constituents, index of microcirculation (I) is calculated by formula: , where M is index of microcirculation in perfusion units, α - mean-square deviation, Amax - maximal amplitude in each group of fluctuations of amplitude-frequency spectrum; Fmax - maximal frequency in each group of fluctuations; α - slow rhythms 1-3 cycles per a minute, LF - slow rhythms 4-12 cycles a minute, HF - fast rhythms 12-36 per minute; CF - pulse fluctuations. If microcirculation index is less than 0.433 malignant neoplasm of prostate gland is diagnosed, if index of microcirculation is larger than 0.433, benign hyperplasia is diagnosed.
EFFECT: extension of arsenal of means for differential diagnostics of prostate gland cancer.
SUBSTANCE: invention relates to medicine, namely, to urology and can be used for operative tactics in treatment of acute pyelonephritises. In order to estimate indications for operative intervention in case of acute pyelonephritis, by means of ultrasound examination, rate of blood flow in cortical layer of kidney is evaluated. Thickness of kidney parenchyma and its homogeneity are determined, then catheterisation of inflamed kidney is performed and anti-bacterial therapy is prescribed. In one day, repeated ultrasound examination is carried out, and if blood flow in cortical layer deteriorates, thickness of parenchyma either does not reduce or grows, parenchyma heterogeneity enhances, fever persists operative intervention is performed. Method increases accuracy of estimation of patient's state, allows to carry out operative intervention in due time, avoid complications and preserve vitally important organ.
EFFECT: increasing accuracy of estimation of patient's state, ensuring possibility to carry out operative intervention in due time, avoid complications and preserve vitally important organ.
SUBSTANCE: invention concerns ophthalmology and can be used at secondary lifting of an ophthalmotonus after operation of not getting deep scleroticectomy. Before carrying out of descementhoniopuncture after operation of not getting deep scleroticectomy the ultrasonic biomicroscopy of a filtrational pillow in sagittal and frontal projections is spent. According to the ultrasonic biomicroscopy, location of the generated postoperative intrascleral channel in a filtrational pillow is determined and its sizes are defined. The laser descementhoniopuncture is peformed precisely in that part of a filtrational pillow where the intrascleral channel has the maximum size.
EFFECT: rising of efficiency of depression of an ophthalmotonus after carrying out laser descementhoniopuncture at the expense of its carrying out precisely taking into account location of the intracsleral channel at the concrete patient, and also in minimisation of the expense of laser energy for microfistula creation that promotes reduction of such complications at performance of laser descementhoniopuncture as detachnment of a vascular cover, a hemorrhage in a zone of a filtrational pillow.
1 ex, 4 dwg
SUBSTANCE: invention concerns medicine, namely to cardiology. The pharmacological mstress-echocardiography for the patient, including fractional introduction of Dobutaminum from 5 to 40 mkg/kg/min with a 3-minute interval is spent. In the absence of gain of frequency of heart contractions to a submaximum level atropine is entered fractionally on 0.25 mg every minute to a total dose no more than 1.0 mg. Thus against the reached submaximum frequency of heart contractions and proceeding infusion of Dobutaminum sublingually one dose of the aerosolic form of Solutio Nitroglycerini of 1 % is entered. Disturbances of local contractility are estimated initially in rest, at introduction of a small dose of Dobutaminum of 10 mg/kg/min, at introduction of the big dose of Dobutaminum of 40 mk/kg/min after inhalation of Nitromintum and on 5th minute of the regenerative period. If at the patient the atypical stenocardia with "the alternative ischemic cascade", characterised that electrocardiographic changes of ischemic character in the form of depression of segment ST and a ventricular arrhythmia precede disturbance of the local contractility, verified by again appearing zones of a myocardium hypokinesis of a left ventricle which is aggravated with reception of nitrates, presence of muscular ponticuluses of coronary arteries is diagnosed. If at the patient the typical stenocardia with "classical" ischemic sequence of reactions on an echocardiogram and an electrocardiogram which is stopped by reception of nitrates the atherosclerotic stenosis of coronary arteries is diagnosed is defined. If clinico-tool implications of an ischemia are not defined, absence of a lesion of a coronary bed is diagnosed.
EFFECT: way allows carrying out differential diagnostics of myocardial ponticuluses of coronary arteries, provides noninvasive technique at high accuracy.
3 dwg, 3 ex
SUBSTANCE: invention concerns ophthalmology and can be used for definition of indications to the differentiated treatment of patients with early ophtalmohypertension after anti-glaucomatous operations of filtering type. In 4-7 days after an anti-glaucomatous operation an ultrasonic biomicroscopy (UBM) is performed. At increase of intraocular pressure (IOP) gonioscopy is performed. At an open intraocular fistula it UBM in dynamics is performed. At safety of a filtrational pillow (FP), occurrence on scanning images of local risings of acoustic density (AD) conjunctivas to 60-80% on edge of FP in a combination to height augmentation of intrascleral cavity (ISC) needling is performed. At disappearance of FP, rising of AP to 60-80 % in all zone of operation, merge of a sclera and a conjunctiva image on scanning images owing to their AP coincidence on value of 60-80%, reduction of ISC height, surgical audit of an operational zone is made.
EFFECT: way allows to improve quality of treatment of patients at the expense of IOP normalisation in some cases in the noninvasive way, and also to choose optimum tactics of conducting the patient, to prolong hypotensive effect of an anti-glaucomatous operation.
SUBSTANCE: invention concerns medicine and is intended for diagnostics of an ischemic clottage of the central vein of a retina. Duplex scanning with colour Doppler mapping on a site of passage of the central vein of a retina (CRV) in an optic nerve depth on distance from 0.75 to 6 mm from the retina surface is performed. The relation of the maximum rate of blood flow Vmax to the minimum rate of blood flow Vmin (Vmax/Vmin) is determined. At value Vmax/Vmin 1-1.4 ischemic type of CRV clottage is diagnosed.
EFFECT: offered way allows diagnosing an ischemic clottage of the central vein of a retina on the basis of ultrasonic quantitative criteria.
SUBSTANCE: invention concerns medicine area, namely to radial methods of diagnostics. The way includes ultrasonic research by the transvaginal gauge in first three days after an ovulation. The gauge is established in a back vault of the vagina. At presence in retrocervical area of the roundish centres of average and raised echogenicity of the non-uniform structure with rough contours or in the presence of similar formations in one of the parametral areas at isthmus level, the retrocervical endometriosis or an endometriosis of sacrouterine ligaments is accordingly diagnosed.
EFFECT: way allows tapping the minimum centres of an endometriosis at the expense of use of an ovulatory liquid as contrast.
SUBSTANCE: method involves carrying out ultrasonic scanning examination of subclavian artery over its whole extent in physiological arm position with arterial blood pressure being measured in the middle one third of the arm. Next, when applying compression tests, blood circulation parameters variations are recorded in distal segment of the subclavian artery with arterial blood pressure being concurrently measured. Three degrees of superior thorax aperture syndrome severity are diagnosed depending on reduction of linear blood circulation velocity and arterial blood pressure compared to their initial values. Mild one takes place when linear blood circulation velocity reduction reaches 40% and arterial blood pressure 20% of initial level, moderate one when linear blood circulation velocity reduction reaches 70% and arterial blood pressure 50% and heavy one when linear blood circulation velocity reduction is greater than 70% of initial level and arterial blood pressure is greater than 50% to the extent of no blood circulation manifestation being observed in the subclavian artery.
EFFECT: high accuracy of diagnosis.