ABSTRACT
Intracoronary shunts (IS) are devices for maintaining distal coronary blood flow when placing anastomoses with coronary arteries. The use of IS ensures functional and electrical stability of myocardium during its revascularization on the working heart. There are reports of endothelial damage by IS leading to dysfunction of coronary shunts. This study compares 208 patients with and without IS. Results of surgery were evaluated during hospitalization period. The groups were matched for initial clinical and instrumental characteristics and the number of shunt placements. It was shown that minimally invasive myocardial revascularization with the use of IS when placing distal anastomoses has a number of advantages over similar surgery without IS, viz. smaller degree of intraoperative myocardial lesion, blood loss, and frequency of postoperative complications along with enhanced stability of intraoperative hemodynamics.
Subject(s)
Coronary Artery Disease/surgery , Minimally Invasive Surgical Procedures/methods , Myocardial Revascularization/instrumentation , Stents , Coronary Angiography , Coronary Artery Disease/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prosthesis Design , Retrospective Studies , Treatment OutcomeSubject(s)
Cerebrovascular Disorders/epidemiology , Coronary Artery Bypass/adverse effects , Postoperative Complications , Acute Disease , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/prevention & control , Extracorporeal Circulation , Humans , Minimally Invasive Surgical Procedures , Myocardial Ischemia/surgery , Myocardial Revascularization/methods , Neuroprotective Agents/administration & dosage , Neuroprotective Agents/therapeutic use , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Prognosis , Risk Factors , Stroke/etiology , Stroke/prevention & control , Time FactorsSubject(s)
Ventricular Remodeling , Adrenergic beta-Antagonists/pharmacology , Angioplasty, Balloon, Coronary , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Calcium Channel Blockers/pharmacology , Cardiac Surgical Procedures , Cardiomegaly/physiopathology , Carnitine/pharmacology , Diastole/physiology , Echocardiography, Stress , Heart Aneurysm/physiopathology , Heart Failure/physiopathology , Humans , Magnetic Resonance Imaging , Myocardial Infarction/complications , Myocardial Infarction/pathology , Myocardial Infarction/physiopathology , Myocardial Stunning , Prognosis , Randomized Controlled Trials as Topic , Systole/physiology , Time Factors , Tomography, Emission-Computed , Ventricular Dysfunction, Left/physiopathology , Ventricular Remodeling/drug effects , Ventricular Remodeling/physiologyABSTRACT
Sixteen patients with the X syndrome underwent thallium-201 myocardial scintigraphy. Eleven patients with one-coronary artery disease served as a control group. During bicycle ergometry all the 16 patients showed various degrees of local myocardial perfusion impairments. The foci were located in the basins of various coronary vessels. Impaired myocardial perfusion in patients with the X syndrome was similar to that in patients with moderate, but hemodynamically significant stenosis of a coronary artery. At the same time the impairments were significantly less pronounced than in those with critical stenosis of a coronary artery. Thus, patients with the X syndrome have not only clinical signs of coronary heart disease (anginal episodes), but they also have marked myocardial perfusion impairments during exercise.
