RESUMO
The article deals with intraoperative assessment of the blood flow in the coronary arteries and internal thoracic artery before and after myocardial revascularization. This is accompanied and followed by ultrasonographic characteristics of the coronary blood flow before and after surgical intervention, as well as competence of anastomoses and functional state of revascularization depending on the degree of the atherosclerotic lesion and the diameter of coronary arteries. The average linear and volumetric velocities of the blood flow in the coronary arteries were found to depend upon the degree of the lesion of coronary arteries, the diameter and capacity of the coronary bed. The work was based on studying a total of forty-eight patients presenting with coronary artery disease and subjected to myocardial revascularization using the internal thoracic artery (ITA). Also determined was efficacy of myocardial revascularization in different diameters of the coronary arteries and parameters of the ITA blood flow.
Assuntos
Ponte de Artéria Coronária/métodos , Doença da Artéria Coronariana/fisiopatologia , Doença da Artéria Coronariana/cirurgia , Vasos Coronários , Artéria Torácica Interna/cirurgia , Ultrassonografia Doppler em Cores/métodos , Idoso , Anastomose Cirúrgica/métodos , Velocidade do Fluxo Sanguíneo , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/etiologia , Vasos Coronários/patologia , Vasos Coronários/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/métodos , Placa Aterosclerótica/complicações , Placa Aterosclerótica/patologia , Placa Aterosclerótica/fisiopatologia , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
The article is dedicated to comparative analysis of surgical management of elderly and aged patients presenting with complicated forms of coronary artery disease (CAD). Suggested herein is an algorithm of concerning the choice of methods aimed at surgical correction of postinfarction aneurysms of the right ventricle of the heart and postinfarction ruptures of the interventricular septum in these patients, depending on the morphological structure of the right-ventricular postinfarction aneurysms and postinfarction ruptures of the interventricular septum, followed by determining the incidence rate of using "complete" and "incomplete" myocardial revascularization in elderly and aged patients with complicated forms of CAD depending on peculiarities of the coronary blood flow. Also considered herein is efficacy of preventing rethrombosis following correction of right-ventricular postinfarction aneurysms and thrombectomy. The article is based on studying a total of forty-two 60-to-78-year-old patients with CAD. The measures taken made it possible to decrease postoperative lethality and postoperative complications rate in the patients concerned.
