RESUMO
A new combined approach to surgical treatment of coronary heart disease is recommended: direct myocardial revascularization (mammary-coronary and aorto-coronary bypass) to recover coronary flow; partial ileo-shunting to control hyperlipoproteinemia, and Arnulf's plexectomy (heart denervation) to eliminate vasospastic component. The sequence of operations can be altered depending on the diagnostic findings. Each operation can be performed independently or in combination with others. Operations were performed in 315 patients. The follow-up covered up to 8 years. Long-term patency of mammary-coronary shunts was 93.5%, and that of autovenous shunts was 65%. Lipid composition showed a stable normalization and signs of coronary spasm disappeared.
Assuntos
Doença da Artéria Coronariana/cirurgia , Coração/inervação , Revascularização Miocárdica/métodos , Simpatectomia/métodos , Adulto , Ponte de Artéria Coronária , Feminino , Humanos , Anastomose de Artéria Torácica Interna-Coronária , Masculino , Pessoa de Meia-Idade , Revascularização Miocárdica/reabilitação , Simpatectomia/reabilitação , Avaliação da Capacidade de TrabalhoRESUMO
An original technique developed by the authors was used in 51 experiments on dogs. Under study were the ECG-dynamics, the volume of the retrograde bloodflow and blood pressure in the splenic and anterior interventricular arteries before and after creating the retrograde spleno-coronary anastomosis. The results of studies of hemodynamics at this operation have confirmed its physiological adequacy.
Assuntos
Vasos Coronários/cirurgia , Revascularização Miocárdica/métodos , Artéria Esplênica/cirurgia , Animais , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Cães , Eletrocardiografia , Coração/fisiologiaRESUMO
Under consideration is a special kind of mammary-coronary anastomosis--a retrograde mammary-coronary anastomosis, first suggested by the authors. An anteretrograde mammary-coronary anastomosis was performed in 104 patients, a retrograde one--in 6. The use of a retrograde mammary-coronary anastomosis yielded favourable results, which in some cases are remained for 4-5 years.
