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Thirty-nine patients with a diagnosis of common arterial trunk and high pulmonary hypertension were examined. Radical correction of the anomaly was performed in 22 patients with a hospital lethality of 36%. Residual pulmonary hypertension was the cause of death in all cases. Results of surgical treatment as well as the indexes of hemodynamics and biopsy and autopsy data were analyzed during the investigation.

The results of intracardiac examination of 37 patients with anomalous origin of the left coronary artery from the pulmonary trunk were studied. On the basis of anatomo-angiographic++ comparisons the authors point out the characteristic features of coronary circulation and affection of the left ventricular myocardium which determine the clinical manifestations of its dysfunction. The functional condition of the left ventricle was appraised depending on the character of development of the intercoronary collaterals.

From analysis of the findings of intracardiac examination of 35 patients with congenital fistulas of the coronary arteries the authors discuss the angiographic semeiotics of the anomaly and the mechanism of disorders of coronary circulation. The pathophysiology of the anomaly is determined by the amount of blood shunted through the fistula, the location of the fistula (whether in the proximal or distal segment of the artery), and the perfusion deficit of the distal segment of the involved artery. Fistulas with a large volume of the shunt may be accompanied both with ischemic changes in the basin of the affected coronary artery and with regional disorders of myocardial perfusion in the adjacent basins (intact coronary arteries). The last named is due to the phenomenon of "stealing" the adjacent coronary trunk. The absence of electrocardiographic signs of focal disorders cannot be considered a sign of a hemodynamically insignificant fistula because an ECG of rest does not always reflect the state of the coronary blood flow in the basin of the involved vessel. Evidence of this are asymptomatic coronary insufficiency and disorders of myocardial perfusion which are revealed by exercise tolerance tests and scintigraphy of the myocardium in patients with a normal ECG.

Intracardiac hemodynamic data obtained at catheterization of the heart in 110 patients with complete transpositions of major vessels (CTMV) are reviewed. The patients were divided into 6 hemodynamic groups depending on the presence of concomitant heart diseases. The age of the patients varied between 22 hours and 12 years. Blood oxygen saturation and pressure inside the cardiac cavities and the major vessels, total pulmonary and total peripheral resistance, pulmonary and systemic blood flow, effective pulmonary blood flow and intercavity pressure gradient were measured. Hemodynamic changes in patients with CTMV were shown to be associated with concomitant heart diseases. Low left-ventricular systolic blood pressure, an interatrial pressure gradient and high oxygen saturation of the blood in a pulmonary artery, as compared to the respective values in a systemic artery were the most specific features in these patients.