Myocardial Surgical Revascularization in Patients with Reduced Left Ventricular Ejection Fraction.

Background: Myocardial surgical revascularization in patients with low left ventricular ejection fraction (LVEF) is accompanied by a high rate of morbidity and mortality. Objective: The aim of this study was to investigate and eliminate the reasons for the most common perioperative and postoperative complications. Methods: A total of 64 were analyzed. of patients during 2019 who underwent coronary artery bypass grafting (CABG), average age 61.29±9.12 years. Results: Out of the total number of operated patients, there were 16 women and 48 men. Patients were divided into two groups. The first group consisted of patients who underwent surgery with the use of cardiopulmonary bypass (cCABG-CPB) and the second group those who underwent surgery without the use of cardiopulmonary bypass (OPCAB). In 41 patients, myocardial infarction was previously recorded. Critical stenosis of the main trunk of the left coronary artery was present in 14 patients. The incidence of postoperative complications was higher in the cCABG-CPB 16/10 group (p0.030). Conclusion: In our study, we confirmed that myocardial revascularization is justified, especially in the case of multivessel coronary disease. In the long term, it significantly improves the systolic function of the left ventricle, and thus and quality and length of life.

Inotropic and Mechanical Support of Critically Ill Patient after Cardiac Surgery.

INTRODUCTION: Cardiac surgery patients often need inotropic support to establish hemodynamic stability and adequate oxygen supply. The management of patients with coronary vascular disease can be challenging especially in patients with severe left ventricular dysfunction and critical left main or severe triple vessel disease. METHODS: Article has descriptive character and presents a case report of 58 years old male patient who was admitted to our hospital due to planned coronary bypass surgery. RESULTS: Applying inotropic support, IABP and adequate volume management during surgery and post surgery period in ICU has led to hemodynamic stability. Leading to the recovery of the patient and hospital discharge. DISCUSSION: Given the availability of the treatment options, inotropic and mechanical support played a major role to produce the positive outcome in the presented case. Many factors were unfavourable, extreme hypotension, high lactate and creatining levels, mechanical ventilation and related complications.

Successful Treatment of Cardiac Tamponade with Corticosteroids After Surgical Myocardial Revascularization: Case Report.

AIM: The aim of this case report is to show the significance of the cardiac tamponade, it's timely diagnosis and to present the unusual approach of the treatment. That was conducted with corticosteroids when the surgical procedure gave no results in rare cases like this. CASE REPORT: This paper presents the case of a man aged 72 years with a verified tamponade of pericardium. A large pericardial effusion with tamponade signs was verified by ultrasound and computerized tomography (CT) of the chest in a hemodynamically stable patient, and in the inability to evacuate the same, with pericardial fenestration, was successfully treated with corticosteroids. CONCLUSION: A large pericardial effusion with the signs of tamponade verified by echocardiography and computerized tomography, in hemodynamically stable patient, and in the inability to evacuate the same by fenestration, was treated successfully with corticosteroids.