[Comparison of clinical and postmortem evaluation of coronary artery stenosis: data on patients who died after coronary artery bypass surgery]. / Sravnenie prizhiznennoi i posmertnoi otsenki stenozov venechnykh arterii (dannye umershikh posle operatsii aortokoronarnogo shuntirovaniia).

Comparison of quantitative clinical angiographic data with postmortem coronary angiographic and visual evaluation of transversal sections of coronary arteries (CA) data was made. CA of 25 patients who died after coronary artery bypass surgery were investigated. Comparison of clinical and postmortem angiographic data showed more frequent underestimation (12%) and overestimation (12%) of stenosis in clinical angiography in cases of right CA injury. Comparison of clinical angiography and evaluation of coronary stenosis on transversal sections showed significant underestimation of stenosis in cases of left main branch (36%) and right CA (32%) injuries. Use of more projections in clinical angiography, evaluation of artery diameter along the whole length of the vessel, investigation of relationship between CA caliber and type of artery branching may improve clinical diagnosis of CA stenosis.

[Transesophageal electrostimulation of the atria in assessing the degree of the coronary bed lesion in ischemic heart disease patients]. / Chrespishchevodnaia élektrostimuliatsiia predserdii pri otsenke stepeni porazheniia koronarnogo rusla u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Electrocardiographic changes in response to esophageal atrial electrostimulation were examined in relation to the severity of coronary-bed affection in 99 patients with suspected coronary heart disease. Esophageal atrial electrostimulation was equal, in terms of specificity and sensitivity (73 and 78%, respectively), to bicycle ergometry (77 and 74%), and was superior to it by far in terms of adjustment to diagnostic electrocardiographic criteria. A direct relationship was demonstrated between total ST depression induced by esophageal atrial electrostimulation and the extent of coronary-bed affection expressed as the number of affected coronary arteries or the impaired blood supply area.

[Technical potentials for performing intravital aortocoronary shunting in sudden death from ischemic heart disease (based on postmortem coronary angiographic data)]. / Tekhnicheskie vozmozhnosti vypolneniia prizhiznennogo aortokoronarnogo shuntirovaniia u vnezapno umershikh ot ishemicheskoi bolezni serdtsa (po dannym posmertnoi koronarografii).

Technical feasibility of aortocoronary shunting was examined retrospectively in 70 cases where sudden coronary death had occurred outside of hospital. Postmortem coronary angiograms, coronary arterial cross sections made at 5 mm intervals, and the nature and spread of focal myocardial lesions were studied. A coronary artery with more than 50% of its lumen affected in the proximal or middle part, but no significant narrowings in the distal channel, was considered shuntable if myocardial focal lesions did not exceed 15% of left-ventricular and interventricular-septum volume. Complete myocardial revascularization was found to be technically feasible in 36.2% of sudden coronary deaths and partial revascularization, in 33.3%, whereas in 30.5% myocardial revascularization proved technically impossible.

[Elaboration of criteria for selection of patients with chronic ischemic heart disease for direct myocardial revascularization surgery]. / Razrabotka kriteriev otbora bol'nykh khronicheskoi ishemicheskoi bolezn'iu serdtsa na operatsiiu priamoi revaskuliarizatsii miokarda.

Indications for direct myocardial revascularization were specified on the basis of a new parameter: the disrupted myocardial blood supply zone (DBSZ). Absolute indications for the procedure included: a more than 50% narrowing in the diameter of the main trunk of the left coronary artery; two or 3 vessels affected with the DBSZ accounting for at least 75% of the left-ventricular and interventricular-septum weight. Relative indications included: two or three affected vessels with the DBSZ covering between 50 and 75% of the left-ventricular and interventricular-septum weight; and a more than 50% isolated proximal narrowing of the diameter of the anterior interventricular branch with any type of coronary blood supply, of the right coronary artery, with types 10:10 and 11:9, and of the circumflex branch, with types 5:15 and 6:14.

[Sudden death outside the hospital from coronary heart disease: the state of the intercoronary artery collaterals]. / Vnezapnaia vnebol'nichnaia smert' ot koronarnoi bolezni serdtsa: sostoianie mezhbasseinovykh kollateralei venechnykh arterii.

By means of postmortem selective coronary angiography coronary collaterals of 55 sudden out-of-hospital coronary death victims were investigated. The collaterals were found in most (58,5%) sudden coronary death cases. There was no correlation between the presence of coronary collaterals, on the one hand, and ischaemic heart disease symptoms during the life and focal myocardial lesions in deceased persons, on the other. The investigation showed the maximal formation of collaterals in cases with asymmetrical obstructive lesions of the right and left coronary arteries. This is in agreement with a hypothesis claiming the coronary collateral formation to be dependent on the pressure gradient between individual coronary arteries.

[Quantitative evaluation of the zone of impaired myocardial blood supply by topograms constructed on the basis of coronarograms]. / Kolichestvennaia otsenka zony narushennogo krovosnabzheniia miokarda po topogrammam, postroennym na osnovanii koronarogramm.

Using the suggested technique for the determination of the extension of the impaired blood supply zone, an analysis was made of the data provided by the pathomorphologic examination of the hearts of 30 controls and 131 patients with chronic coronary heart disease (CHD). The method proposed is based on the establishment of the ratio of the myocardial masses of the areas supplied by the anterior interventricular branch, the circumflex branch and the right coronary artery. The index proposed depends on the type of coronary blood supply and the localization of coronary artery constriction. The analysis of the clinical data and the survival of patients with chronic CHD has shown that the extension of the zone of impaired blood supply is an important diagnostic and prognostic parameter in CHD.

[Determination of the types of coronary blood supply by the mass of the blood-supplied zones established on the basis of coronary radiograms]. / Ustanovlenie tipov koronarnogo krovosnabzheniia po sootnosheniiu mass snabzhaemykh krov'iu zon, opredeliaemykh na osnovanii koronarogramm.

The dominant coronary arteries and coronary supply types were determined by means of coronary topograms plotted from 305 coronary angiograms, including 30 postmortem ones. Coronary supply types were expressed by the following ratios of numeral values: 5:15, 6:14, 7:13, 8:12, 9:11, 10:10, 11:9, which corresponded to mass scores of the areas supplied through the right (RCA) and the left (LCA) coronary artery. Such determination of coronary supply types in postmortem examinations was verified by separate weighing of the RCA and LCA basins. The data from both methods of investigation showed good correlation (r = 0.977). By separate weighing of the RCA-supplied regions as well as of the anterior interventricular and circumflex branches the role of each coronary artery in supplying the left ventricle and the interventricular septum was elucidated in relation to a coronary supply type.

[Methodological problems of quantitative and combined evaluation of the asynergy and volume of the left heart ventricle by contrast ventriculography in patients with ischemic heart disease]. / Metodicheskie problemy kolichestvennoi i kompleksnoi otsenki asinergii i ob''emov levogo zheludochka pri ishemicheskoi bolezni serdtsa po dannym kontrastnoi ventrikulografii.

Regional analysis was performed in 24 patients with various forms of left ventricular (LV) asynergy. Three quantitative methods of regional analysis with different types of superposition (SP) of end-phasic contours (EPC) were compared: the radial method, taking into account the dislocation of basal structures, was more sensitive (p less than 0.02) in detecting apical asynergy, as compared to the chordal method, or the radial procedure using a different type of SP. The authors used the radial method of regional analysis for estimating LV volumes in 53 patients. The data obtained with this method were in good correlation with those of the conventional "area-length" technique. It is concluded that the radial method taking into account the dislocation of basal structures is useful in complex and quantitative analysis of regional as well as systemic parameters of LV function.