[The surfactant system and ultrastructure of the lungs after surgical correction of cardiac defects during extracorporeal circulation].
Using bronchoalveolar lavage (BAL), two-dimensional thin-layer chromatography, and electron, microscopy, the surfactant system and ultrastructure of the lung were examined in 32 patients with mitral valvular disease before cardiac interventions, after closed mitral commissurotomy, and surgeries under extracorporeal circulation (EC). The magnitude of changes in the pulmonary surfactant and structure was shown to be determined by the degree of circulatory decompensation and to vary with duration of the disease. In 23.7% of the patients, there were significant changes in the pulmonary surfactant system and ultrastructure, which were characterized by phospholipid metabolic disturbances in the surfactant, destructure of osmophilic lamellated corpuscles of type II alveolocytes (AII), decrease in their relative volume, a substantial increase in the minimal BAL superficial tension, and aerohematic barrier fibrosis. Concurrent with the magnitude of morphological changes in the lung, time of EC, composition of a perfusate, the presurgical abnormality of the surfactant system is essential to the development of its postperfusion insufficiency and pulmonary dysfunction. The pulmonary ultrastructural alterations in these patients were expressed by impairment in capillary endotheliocytes, their accumulation of leucocytic aggregates, interstitial and intracellular edemas, partial alveolar collapse, destructive-and-necrotic and compensatory-and-adaptative changes in AII. The above abnormalities were seen in 27.7% of the patients operated on under EC.
Perezhogin
E V
EV
Zaĭtseva
K K
KK
Skorik
V I
VI
Grigor'eva
Iu A
IuA
Aleshkin
N G
NG
D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000032:analysis; D004487:Edema / Q000473:pathology; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology / Q000648:ultrastructure*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D009336:Necrosis; D010743:Phospholipids / Q000378:metabolism; D011663:Pulmonary Surfactants / Q000032:analysis*
D010743:Phospholipids; D011663:Pulmonary Surfactants
Surfaktantnaia sistema i ul'trastruktura legkikh posle khirurgicheskoĭ korrektsii porokov serdtsa v usloviiakh iskusstvennogo krovoobrashcheniia.