[Evaluation of late results of aortocoronary bypass in patients with ischemic heart disease in relation to the bypass function]. / Otsenka otdalennykh rezul'tatov aortokoronarnogo shuntirovaniia u bol'nykh ishemicheskoi bolezn'iu serdtsa v zavisimosti ot funktsional'nogo sostoianiia shuntov.

The authors analyse 82 patients with aggravation of their clinical condition in the late-term periods after aortocoronary shunting. All were subjected to coronaroshuntography 3.6 +/- +/- 0.5 years on the average, after the operation. The main noninvasive criteria of impaired functioning of the shunts were: increase of the degree of angina pectoris (functional class III-IV according to the Canadian classification), diminished tolerance to physical exertion, appearance of "active" myocardial ischemia. Disturbed functioning of the shunts was mainly manifested within the first year, while progression of atherosclerotic changes in the unshunted arteries--in later periods. The main causes of incompetence of the shunts were: small diameter of the shunted arteries, low rate of blood flow in the shunts, and feverish condition of patients lasting for a long time after the operation.

[Dynamics of clinical and functional parameters in patients with ischemic heart disease after aortocoronary bypass surgery]. / Dinamika klinicheskikh i funktsional'nykh pokazatelei u bol'nykh ishemicheskoi bolezn'iu serdtsa, podvergshikhsia aortokoronarnomu shuntirovaniiu.

Complete myocardial revascularization was examined for effects on long-term results of aortocoronary bypass surgery in 219 patients. Myocardial revascularization was proposed to be divided into: (1) truely complete; (2) tentatively complete; and (3) partial. Clinical and functional parameters deteriorated in tentatively complete and partial myocardial revascularization as compared with truely complete revascularization. A positive dynamics in abnormal Q wave signs was found in 9% of the patients after the surgery in the presence of the wave in ECG leads corresponding to the anterior left ventricular wall, in the absence of signs of myocardial asynergy prior to the surgery, and on complete recovery of blood flow in the shunts supplying the diseased myocardial areas.

[Late results of aortocoronary shunting in ischemic heart disease patients in relation to the severity of the coronary lesion and degree of myocardial revascularization]. / Otdalennye rezul'taty aortokoronarnogo shuntirovaniia u bol'nykh ishemicheskoi bolezn'iu serdtsa v zavisimosti ot tiazhesti porazheniia koronarnykh arterii i stepeni revaskuliarizatsii miokarda.

Long-term results of aortocoronary shunting are reviewed in 219 coronary patients with reference to the severity of coronary arterial damage and myocardial revascularization. Functional class of angina pectoris declined 2.5-fold postoperatively and was 1.6 +/- 0.14 at long-term follow-up. The success rate reached 74%. Survival rate was 87.3%, including hospital mortality, and long-term survival was 92.1%. Acute coronary insufficiency was the principal cause of compromised success and survival rates. The operation was particularly effective in patients with first- or second-degree total coronary arterial lesion and true complete myocardial revascularization.