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1.
Khirurgiia (Mosk) ; (5): 51-57, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38785239

RESUMO

OBJECTIVE: To evaluate the clinical effectiveness of bilateral internal mammary artery grafting over long-term (15 years) postoperative period. MATERIAL AND METHODS: There were 276 patients divided into two groups: 135 patients (group A) underwent bilateral internal mammary artery grafting and 141 patients (group B) underwent unilateral internal mammary artery grafting together with venous bypass grafts. On-pump surgeries and cardioplegia, parallel CPB and on-pump procedures were performed in equal proportions. Mean age of patients was 57.3±7.6 years. Diabetes mellitus was detected in 21 (15.5%) and 24 (19.1%) patients, respectively (p>0.05). Mean LV ejection fraction was 55.4±9.9%, revascularization index - 3.1±0.8 and 3.0±0.7, respectively. In the 1st group, 43 patients underwent bilateral internal mammary artery grafting alone. Autovenous grafts were additionally used in other 84 patients. RESULTS: Ten-year survival exceeded 90% in both groups. Freedom from adverse cardiac events after 15 years was significantly higher in group A (77.3% vs. 59.3%, p=0.018). In group A, 16 patients died throughout this period due to cancer (50%), myocardial infarction (12.5%), stroke (18.8%) and complications of diabetes mellitus (6.3%). In group B, 22 patients died mainly from cardiac causes (myocardial infarction - 40.9%, cancer - 27.3%). CONCLUSION: Bilateral internal mammary artery grafting has obvious advantages over traditional coronary artery bypass grafting. If we take into account higher proportion of cardiac causes in structure of mortality in group B, we can talk about positive impact of bilateral internal mammary artery grafting not only on the quality of life, but also on life expectancy in long-term postoperative period.


Assuntos
Artéria Torácica Interna , Complicações Pós-Operatórias , Humanos , Pessoa de Meia-Idade , Feminino , Masculino , Artéria Torácica Interna/transplante , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Federação Russa/epidemiologia , Idoso , Doença da Artéria Coronariana/cirurgia , Doença da Artéria Coronariana/complicações , Anastomose de Artéria Torácica Interna-Coronária/métodos , Anastomose de Artéria Torácica Interna-Coronária/efeitos adversos , Ponte de Artéria Coronária/métodos , Ponte de Artéria Coronária/efeitos adversos , Resultado do Tratamento , Qualidade de Vida , Efeitos Adversos de Longa Duração/etiologia , Efeitos Adversos de Longa Duração/diagnóstico , Efeitos Adversos de Longa Duração/epidemiologia , Avaliação de Processos e Resultados em Cuidados de Saúde
2.
Khirurgiia (Mosk) ; (3): 74-81, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32271741

RESUMO

OBJECTIVE: To evaluate safety of coronary artery bypass surgery using bilateral internal mammary artery and effectiveness of this procedure in long-term postoperative period. MATERIAL AND METHODS: The study involved 129 patients who underwent CABG for the period 2006-2007. There were 2 groups of patients depending on surgical strategy: group 1 (n=61) - double IMA harvesting, group 2 (n=68) - CABG using single IMA. Short-term results were compared using standard statistical methods. Long-term survival was compared using Kaplan-Meyer method. RESULTS: Revascularization index was 3.014±0.76 in the 1st group and 3.1±0.73 in the 2nd group (p>0.05). In-hospital mortality was 0% and 1.47%, respectively (p> 0.05). A 10-year survival was 95.1% and 91.2%, respectively (p>0.05). Freedom from cardiac events (mortality, myocardial infarction, recurrent angina pectoris) was significantly different (95% vs. 81%, p<0.05). CONCLUSION: Significantly lower rate of adverse cardiac events in long-term postoperative period in comparison with conventional CABG clearly demonstrates high quality of life after coronary artery bypass surgery using bilateral internal mammary artery for a long time. Therefore, this procedure is preferred in patients with coronary artery disease.


Assuntos
Ponte de Artéria Coronária/métodos , Doença da Artéria Coronariana/cirurgia , Artéria Torácica Interna/transplante , Seguimentos , Humanos , Qualidade de Vida , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
3.
Khirurgiia (Mosk) ; (2): 5-12, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32105250

RESUMO

OBJECTIVE: To optimize surgical treatment of patients aged over 70 years with coronary artery disease. MATERIAL AND METHODS: There were 398 patients aged over 70 years with coronary artery disease for the period 2006-2017. All patients were divided into 3 groups: group 1 - on-pump coronary artery bypass grafting (CABG) with cardiac arrest; group 2 - on-pump beating heart CABG, group 3 - off-pump CABG. RESULTS: On-pump beating heart CABG in patients over 70 years old is followed by reduced incidence of perioperative complications including acute heart failure, acute respiratory failure, neurological complications, reduced length of ICU- and hospital-stay compared with on-pump CABG and cardiac arrest. However, off-pump CABG is optimal in advanced age patients because this approach reduces duration of surgery, intraoperative blood loss, incidence of acute heart failure, neurological complications and cardiac rhythm disturbances. Postoperative annual and 5-year survival rates were 98.1 and 84.2%, respectively. CONCLUSION: Off-pump CABG is preferable in advanced age patients. Surgical treatment of these patients is characterized by high clinical efficacy in long-term period after surgery.


Assuntos
Ponte de Artéria Coronária sem Circulação Extracorpórea , Doença da Artéria Coronariana , Idoso , Ponte de Artéria Coronária , Humanos , Complicações Pós-Operatórias , Estudos Retrospectivos , Falha de Tratamento , Resultado do Tratamento
4.
Ter Arkh ; 91(9): 145-149, 2019 Sep 15.
Artigo em Russo | MEDLINE | ID: mdl-32598826

RESUMO

Now there is a relevant development of the new biomarkers capable to serve as the instrument of early diagnostics of a disease for the purpose of selection of a pharmacotherapy and further monitoring of its efficiency. Galektin-3 is the atypical representative of the family of galektin. Its participation in fibrosis, remodeling of heart, the immunologic answer and inflammatory reactions are shown. Prognostic value is discussed and diagnostic opportunities of Galektin-3 at CHF are widely studied and take root into clinical practice. Now a great deal of research devoted to the studying of Galektin-3, possibilities of its use as a biomarker at diagnostics, forecasting of outcomes and the choice of therapeutic strategy at other cardiovascular diseases has been conducted.


Assuntos
Insuficiência Cardíaca , Biomarcadores , Doença Crônica , Humanos , Inflamação , Prognóstico
5.
Khirurgiia (Mosk) ; (7): 4-7, 2018.
Artigo em Russo | MEDLINE | ID: mdl-29992918

RESUMO

Academician B.V. Petrovsky had considerable impact on coronary surgery development in our country. Current Russian coronary surgery comparable with world standards is based on scientific and practical initiatives initiated and developed by B.V. Petrovsky and his students.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Federação Russa
6.
Anesteziol Reanimatol ; (2): 73-8, 2013.
Artigo em Russo | MEDLINE | ID: mdl-24000657

RESUMO

A comparative analysis of preoperative risk factors and postoperative period flow in patients older than 70 years (58 people) in comparison with control group aged 40-63 years (62 patients), undergoing myocardial revasculization was conducted. . Significantly higher rates of rhythm disturbances, arterial hypertension, lung diseases, chronic renal insufficiency, atherosclerotic carotid artery disease, lower limb atherosclerotic disease were found in patients older than 70 years preoperatively. It leads to postoperative complications and requires special preoperative correction. Complications incidence after CABG was higher by 1.7 times in patients older than 70 versus control group. The most frequent complications were: rhythm disturbances (in 5 times more often, than control group), respiratory failure (which in 70% of cases was caused by COPD), cerebral complications (in 2,5 times more often, than in control group). Myocardial revasculization surgery in elderly patients is effective treatment method and can be performed with good immediate results.


Assuntos
Ponte de Artéria Coronária/métodos , Isquemia Miocárdica/cirurgia , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Retrospectivos
7.
Kardiologiia ; 53(10): 4-9, 2013.
Artigo em Russo | MEDLINE | ID: mdl-24645549

RESUMO

MATERIAL AND METHODS: We followed 619 patients with ischemic heart disease (IHD) and multivessel involvement of coronary arteries: 317 patients subjected to coronary artery bypass grafting (CABG, group 1) and 302 patients subjected to multivessel percutaneous coronary intervention (PCI, group 2) with implantation of drug eluting stents. Both groups had comparable clinical characteristics. During hospitalization we registered deaths and unfavorable cardiological and cerebrovascular events. In remote period after revascularization we assessed survival, angina recurrences and related repeat revascularizations, and rate of severe cardiovascular complications (composite of deaths, acute myocardial infarctions [AMI], stroke, and repeat myocardial revascularizations). RESULTS: During hospitalization there were no significant differences between groups by parameters studied: death rate was 1.7 and 0.9%, that of AMI 2.6 and 1.9%, of stroke 0.9% and 0, of composite of death, AMI, and stroke 5.1 and 1.9% (p = 0.37) in groups 1 and 2, respectively. Survival in remote period was 90.2 (group 1) and 92.7% (group 2). Comparison of Kaplan-Meier survival curves also revealed no significant differences between groups. Angina recurrence/repeat revascularization took place in 54 (17.0%) and in 64 (21.2%) patients in groups 1 and 2, respectively (p = 0.128). Repeat revascularization was carried out in 32 of 54 patients (59.3%) in group 1 and in 58 Of 64 patients (90.6%) in group 2. Rate of severe unfavorable events during whole period of follow up was 33.1% in group 1 and 30.5% in group 2 (p > 0.05). CONCLUSION: In IHD patients with multivessel coronary artery involvement and low Syntax Score immediate and long term (5 year) results of stenting with drug eluting stents are not inferior to results of CABG.


Assuntos
Ponte de Artéria Coronária/métodos , Doença da Artéria Coronariana/cirurgia , Stents Farmacológicos , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/mortalidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Federação Russa/epidemiologia , Índice de Gravidade de Doença , Taxa de Sobrevida/tendências , Resultado do Tratamento
8.
Anesteziol Reanimatol ; (3): 67-71, 2012.
Artigo em Russo | MEDLINE | ID: mdl-22993930

RESUMO

The aim is to investigate the effectiveness of SIRS pharmacological correction in patients after CABG when adding clarithromycin to the standard antibacterial therapy. Patients of the 1st group (n=25) received Klacid- CP ("Abbott") in perioperative period plus to standard antibacterial therapy (3rd generation cephalosporins), patients of 2nd group received standard therapy. At 1st screening stage, as well as on the 2-nd and 4-th day after operation were recorded data of an anamnesis, concomitant pathology, examination, were measured the level of white blood cells, LII, biochemical blood analysis (CRP), defined the concentration of interleukins (IL-1, 6, 8,10,12) and TNF - a. In all studied patients, laboratory' and physical data did not go beyond the reference values, intraoperation data, blood loss and ALV duration did not statistically differ. According to the results of research in patients of both groups there were manifestations of SIRS in the form of reliable significant increase in body temperature, as well as the level of Il-6, IL-8, CRP, LII, TNF - a, leukocytosis. While in the clarithromycin group body temperature was significantly lower in all time points. The level of CRP for the 4th day in 1.5 times, and TNF in 4 times less than in the control group, and the values of anti-inflammatory IL-10 to the 2nd day, on the contrary almost in 2 times higher than those in the control group. Thus, the obtained data confirmed that the CABG is accompanied by non-inflammatory SIRS development. At the same time clarithromycin gives an independent proven anti-inflammatory effect and can be recommended for application in the schemes of prophylactic antimicrobial therapy during perioperative period in this category of patients.


Assuntos
Antibacterianos/uso terapêutico , Claritromicina/uso terapêutico , Revascularização Miocárdica , Complicações Pós-Operatórias/prevenção & controle , Síndrome de Resposta Inflamatória Sistêmica/prevenção & controle , Antibacterianos/administração & dosagem , Biomarcadores/sangue , Claritromicina/administração & dosagem , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/imunologia , Estudos Prospectivos , Índice de Gravidade de Doença , Síndrome de Resposta Inflamatória Sistêmica/sangue , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Síndrome de Resposta Inflamatória Sistêmica/imunologia , Resultado do Tratamento
9.
Angiol Sosud Khir ; 11(3): 83-95, 2005.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-16439953

RESUMO

UNLABELLED: The aim of the present study was to compare the short- arid long-term clinical results in CAD patients with an initial LV ejection fraction below 35% after coronary stenting and coronary artery bypass grafting (CABG). METHODS AND RESULTS: the study accrued 94 CAD patients with an initial LV ejection fraction below 35%. As dependent on the revascularization techniques performed, the patients were distributed into two groups. The first group comprised patients after intracoronary stenting. The second group included patients who had undergone CABG. Both groups were comparable in terms of the basic clinical criteria. The short-term clinical success of intervention in CS and CABG groups accounted for 97.6% and 97.7% respectively (p>0.05). The hospital lethality was significantly higher in the CABG group than in the CS group and was quoted as 13.7% versus 2.3% (p<0.05). No significant differences in the clinical status were recorded among patients with the clinical success. In the long-term period, the three-year survival in the CS and CABG groups accounted for 73.2% and 79.1% respectively (p>0.05). The incidence of unfavourable clinical events (UCE) in the CABG group was recorded significantly less frequently than in the CS group and constituted 21.9% versus 39% (p<0.05). Complete "freedom" from angina and UCE in the CABG group was recorded significantly more often among CABG group patients versus the CS group: 79.1% versus 60.9% respectively (p<0.05). CONCLUSION: As regards the immediate clinical efficacy both methods of revascularization are not statistically different. However, CABG is associated with a significantly higher hospital lethality. In turn, in the long-term period with the three-year survival in the study groups being statistically comparable), the incidence of UCE is recorded significantly most frequently in the CS group.


Assuntos
Doença das Coronárias/cirurgia , Revascularização Miocárdica/métodos , Volume Sistólico/fisiologia , Disfunção Ventricular Esquerda/complicações , Doença das Coronárias/complicações , Doença das Coronárias/fisiopatologia , Ecocardiografia sob Estresse , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia
10.
Vestn Ross Akad Med Nauk ; (3): 24-8, 2003.
Artigo em Russo | MEDLINE | ID: mdl-12705046

RESUMO

An analysis, the shaping-up and perfection of the surgical treatment of ischemic heart disease (IHD) by using the method of small-invasion grafting of coronary arteries without applying the artificial bypass blood circulation is described. Indications and contraindications for the surgery of coronary grafting on the working heart and with minimal approach are discussed. Advantages of such surgeries boil down to a smaller trauma, a better cosmetic effect, milder pain, a quicker rehabilitation (with a shorter stay in hospital) and cost-efficiency.


Assuntos
Ponte de Artéria Coronária/instrumentação , Isquemia Miocárdica/prevenção & controle , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Isquemia Miocárdica/cirurgia
11.
Anesteziol Reanimatol ; (5): 21-4, 2002.
Artigo em Russo | MEDLINE | ID: mdl-12611295

RESUMO

The time course of changes in rSO2 were studied in 58 patients during the uncomplicated course of cardiac operations under extracorporeal circulation (EC) and moderate hypothermia. rSO2 was also compared with central hemodynamic parameters, bioelectrical cerebral activity, and hemoglobin oxygen saturation of the bulb of the internal jugular vein (jbSO2). In the pre- and postperfusion period there was a significant correlation of rSO2 and jbSO2 (p = 0.01), yet with a low correlation coefficient (r = 0.348). During EC, no correlation was found between rSO2 and jbSO2 (p = 0.09, r = 0.386). Changes in rSO2, blood pressure, EEC, body temperature were analyzed in 2 groups of patients at the stages of an operation under EC. Group 1 comprised patients with cardiac valvular apparatus lesions and Group 2 included those with coronary heart disease who differed not only in age, but also in the history of mainly cerebrovascular atherosclerotic lesions, hypertensive disease, myocardial infarction, etc. In patients from both groups, a reduction in rSO2 occurred at the beginning of EC and at the maximum of cooling. But if in Group 1 patients, the significant reductions in rSO2 at the beginning of EC coincided both with that in mean blood pressure (BPmean), as compared to the baseline values (from 75.55 +/- 10.68 to 66.5 +/- 11.73 mm Hg, p = 0.01), and with the change in the frequency spectrum of EEC (a decrease in the frequency of the right edge, as compared to the baseline values, from 20.77 +/- 1.44 to 19.58 +/- 1.14 Hz, p = 0.01), in Group 2 patients, all significant decreases in rSO2 were accompanied only by a significant reduction in BPmean, but without changes in the frequency spectrum of EEG. It should be noted that over the uncomplicated course of an operation all changes in rSO2 were in the normal range of age-related values.


Assuntos
Encéfalo/irrigação sanguínea , Procedimentos Cirúrgicos Cardíacos/métodos , Circulação Extracorpórea , Oximetria/métodos , Oxigênio/sangue , Adulto , Anestesia Geral , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória , Oximetria/instrumentação
12.
Khirurgiia (Mosk) ; (3): 38-40, 1996.
Artigo em Russo | MEDLINE | ID: mdl-8965443

RESUMO

A comparative analysis of arterial grafts used for myocardial revascularization has been done. The morphology of arteries, rate and degree of atherosclerotic process were evaluated. 55 thoracic internal arteries, 52 right gastro-epipiolcal arteries, 34 epigastrical inferior arteries have been tested in cadavers of people with signs of coronary heart disease. Arteria thoracica interna appeared to be a vessel with prevalence of elastic elements, while arteria gastro-epiplocia and arteria epigastrica inferior are predominantly muscle-type. Arteria thoracica interna and arteria epigastrica inferior appeared to be rarely affected with atherosclerosis in people under 60 years of age. Atherosclerotic lesions have been found more often in arteria gastro-epiploica without stenotic lesions. In people over 60 years of age the stenotic lesions in arteria thoracica interna and arteria epigastrica are found much more often than in arteria gastro-epiploica. Arteriography should be done in selecting the proper graft for myocardial revascularization.


Assuntos
Ponte de Artéria Coronária/métodos , Doença das Coronárias/cirurgia , Adulto , Cadáver , Doença das Coronárias/patologia , Humanos , Pessoa de Meia-Idade , Transplante Autólogo
13.
Khirurgiia (Mosk) ; (6): 13-4, 1995.
Artigo em Russo | MEDLINE | ID: mdl-8569111

RESUMO

Ten experiments were conducted on nonfixed human cadavers of males and females 50 to 70 years of age. The inferior epigastric artery arises from the medial wall of the external iliac artery 1.0-1.5 cm proximal to the inguinal ligament. Its diameter at the site of its origin varies from 2.5 to 4.0 mm and is 3.25 +/- 0.13 mm on the average. At the level of the umbilical ring the average diameter of the artery is 1.47 +/- 0.03 mm. The total length of the arterial segment which can be used for transplantation varies from 11 to 16.5 cm, being 14.60 +/- 0.48 cm on the average. An approach through an inferomedian incision of the abdominal wall is preferable. The transplant is taken out together with the veins and the surrounding connective tissue. The length and diameter of the inferior epigastric artery are sufficient for using it as an aortocoronary shunt in revascularization of the myocardium in patients with ischemic heart disease.


Assuntos
Ponte de Artéria Coronária/métodos , Artérias Epigástricas/transplante , Idoso , Cadáver , Doença das Coronárias/cirurgia , Artérias Epigástricas/anatomia & histologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Artigo em Russo | MEDLINE | ID: mdl-8312003

RESUMO

Forty-three patients operated on under conditions of aortocoronary bypass were examined. In 29 of them continuous circulation of cold solution in pericardial cavity was combined with antegrade cardioplegia. In 14 routine technique of external myocardial cooling with snow and antegrade crystalloid cardioplegia was employed. Intensive external cooling of the heard helped not only maintain a lower myocardial temperature but permitted also a reduction of temperature gradients between various myocardial sites. This was conducive to a better preservation of energy reserve and contractility of the myocardium.


Assuntos
Ponte de Artéria Coronária/métodos , Parada Cardíaca Induzida/métodos , Anestesia por Inalação , Temperatura Corporal , Coração/fisiopatologia , Parada Cardíaca Induzida/instrumentação , Hemodinâmica , Humanos , Pessoa de Meia-Idade , Isquemia Miocárdica/fisiopatologia , Isquemia Miocárdica/cirurgia
15.
Artigo em Russo | MEDLINE | ID: mdl-8217310

RESUMO

In 21 patients with coronary heart disease, a procedure of protecting the myocardium was used during cardiac surgeries via irrigation of the pericardial cavity with circulating cold solution in combination with cardioplegia into the aortic root. The application of the procedure maintained stable myocardial temperature from 10.26 +/- 1.55 to 11.99 +/- 1.95 degrees C, excluding excessive overcooling and premature warming. The procedure awaits further studies in terms of biochemical changes and morphology of the myocardium at various stages of surgery.


Assuntos
Soluções Cardioplégicas/administração & dosagem , Circulação Extracorpórea/métodos , Parada Cardíaca Induzida/métodos , Adulto , Temperatura Corporal , Circulação Extracorpórea/instrumentação , Feminino , Coração/fisiopatologia , Parada Cardíaca Induzida/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/fisiopatologia , Isquemia Miocárdica/cirurgia , Pericárdio
16.
Kardiologiia ; 32(6): 11-4, 1992 Jun.
Artigo em Russo | MEDLINE | ID: mdl-1405282

RESUMO

The myocardial function and metabolism were assessed in 12 patients with coronary heart disease intraoperatively during aortocoronary bypass surgery. The antioxidative properties of the blood of the heart were found to become lower along with activated peroxidation after the major stage of an arrested heart operation, that correlated with depressed myocardial function.


Assuntos
Ponte de Artéria Coronária , Coração/fisiologia , Reperfusão Miocárdica , Miocárdio/metabolismo , Consumo de Oxigênio , Adulto , Circulação Extracorpórea , Humanos , Pessoa de Meia-Idade , Oxigênio/sangue
17.
Kardiologiia ; 32(6): 77-82, 1992 Jun.
Artigo em Russo | MEDLINE | ID: mdl-1405305

RESUMO

Excursions of the myocardium in its revascularization area were recorded in 70 patients with coronary heart disease. Myocardial dyskinesia correlated with low bypass blood flows, myocardial ischemia and infarction in the area of revascularization at any blood flow values. The evaluation of the diagnostic efficacy of myocardiographic symptoms suggested that myocardiography had some advantages. It was concluded that it was essential to include intraoperative myocardiography into the set of methods for examining patients with coronary heart disease during myocardial revascularizations.


Assuntos
Ponte de Artéria Coronária , Coração/fisiologia , Contração Miocárdica , Adulto , Circulação Coronária , Eletrocardiografia , Circulação Extracorpórea , Humanos , Pessoa de Meia-Idade
18.
Kardiologiia ; 32(2): 21-3, 1992 Feb.
Artigo em Russo | MEDLINE | ID: mdl-1527929

RESUMO

Polycardiography was used to examine myocardial contractile parameters: preejection and ejection periods and contractility coefficient in 90 patients with coronary heart disease running without complications postoperatively following aortocoronary bypass and cardiac aneurysm resection. The magnitude and length of lower myocardial contractility were found to be associated with the baseline extent of coronary and cardiosclerosis, the signs of congestive heart failure, the value of ejection fraction, and intraoperative parameters such as the duration of extracorporeal circulation and myocardial ischemia, the number of shunts and their blood flow. Early drug correction of complications and a scientifically substantiated approach to the physical rehabilitation of those operated on may be applied with due account of the changes in myocardial contractility.


Assuntos
Ponte de Artéria Coronária , Doença das Coronárias/fisiopatologia , Aneurisma Cardíaco/fisiopatologia , Contração Miocárdica/fisiologia , Adulto , Doença das Coronárias/cirurgia , Aneurisma Cardíaco/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Volume Sistólico/fisiologia
19.
Grud Serdechnososudistaia Khir ; (11): 16-8, 1991 Nov.
Artigo em Russo | MEDLINE | ID: mdl-1764302

RESUMO

With growth of the number of primary operations and duration of the postoperative period, there was an obvious tendency towards an increase of the absolute number of patients with recurrent angina pectoris. Among 990 patients who were operated on successively during a period of 9 years, 9% had severe Functional Class III-IV angina pectoris, in whom coronary bypass graphy was indicated to determine the possibility of undertaking a reoperation. The examination was conducted in 61 patients with recurrent marked angina pectoris. Impaired patency of the aortocoronary shunts was found to be the main cause of recurrence. At present, reoperations were carried out in 18 patients, 2 years after the first operation, on the average. The authors claim the immediate results of the reoperations to be satisfactory. The hospital mortality was 5.6%.


Assuntos
Angina Pectoris/cirurgia , Ponte de Artéria Coronária , Angina Pectoris/diagnóstico por imagem , Angiografia Coronária , Humanos , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Recidiva , Reoperação , Fatores de Tempo
20.
Khirurgiia (Mosk) ; (6): 95-8, 1991 Jun.
Artigo em Russo | MEDLINE | ID: mdl-1770748

RESUMO

The article deals with the results of examination of 47 patients with a history of perioperative myocardial infarction after aortocoronary shunting and the findings in 358 persons of the control group who were operated on without this complication. The authors studied the dynamics of changes of the patients' functional condition after aortocoronary shunting, complicated by perioperative myocardial infarction in the late-term postoperative period. A comparative study was conducted of the dynamics of changes of the symptomatic status and the incidence of postoperative myocardial infarction among patients with and those without the complication. Its effect on the occurrence of the clinical picture of chronic circulatory insufficiency was also studied. A search was undertaken in this group for risk factors of the development of recurrent angina pectoris, myocardial infarction, and symptomatology of chronic circulatory insufficiency in the late-term postoperative period. The results of the study showed that perioperative myocardial infarction in the late-term postoperative period does not affect the patient's "character" of life. In the late-term postoperative period symptoms of chronic circulatory insufficiency are encountered in patients with perioperative myocardial infarction, as a rule, in a recurrence of angina pectoris and develop significantly more frequently in initial multiple affection of the coronary arteries.


Assuntos
Angina Pectoris/etiologia , Cardiomiopatia Dilatada/etiologia , Ponte de Artéria Coronária/efeitos adversos , Infarto do Miocárdio/cirurgia , Complicações Pós-Operatórias/etiologia , Adulto , Angina Pectoris/diagnóstico , Cardiomiopatia Dilatada/diagnóstico , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Complicações Pós-Operatórias/diagnóstico , Fatores de Tempo
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