RESUMEN
The authors performed 153 reconstructive vascular operations in patients with associated atherosclerotic lesion of the coronary arteries, abdominal aorta and arteries of the lower extremities. According to the findings of ventriculography and coronarograms, in 13 patients, the inoperable form of the ischemic heart disease was revealed. In all these patients, the vascular operations were performed. The indications for the different reconstructive vascular operations in inoperable coronary pathology have been developed.
Asunto(s)
Aorta Abdominal/cirugía , Enfermedad de la Arteria Coronaria/complicaciones , Arteria Femoral/cirugía , Isquemia/cirugía , Pierna/irrigación sanguínea , Arteria Poplítea/cirugía , Adulto , Anciano , Humanos , Isquemia/complicaciones , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
The literature and original research data on the incidence of combined lesions of coronary arteries, abdominal aorta, and lower-limb vessels are presented. Operative intervention was undertaken in 112 of 170 examined patients with combined coronary and vascular abnormalities. Fifteen patients underwent one-stage reconstruction of the coronary artery and aortofemoral segment; in 57 patients aortocoronary bypass was performed as the first stage; in 40 patients only vascular reconstruction was performed. Operative risks in these patients are discussed, as well as the diagnostic problems, surgical tactics, and the sequence of operation stages in combined coronary and vascular abnormalities.
Asunto(s)
Enfermedades de la Aorta/cirugía , Arteriosclerosis Obliterante/cirugía , Puente de Arteria Coronaria , Enfermedad Coronaria/cirugía , Pierna/irrigación sanguínea , Anastomosis Quirúrgica/métodos , Aorta Abdominal/cirugía , Enfermedades de la Aorta/complicaciones , Arteriosclerosis Obliterante/complicaciones , Enfermedad Coronaria/complicaciones , Arteria Femoral/cirugía , HumanosRESUMEN
Two groups of patients whose ejection fraction was below 0.45, underwent aortocoronary shunting of one to five arteries: patients without myocardial scarry changes (group 1) and those with expansive intra- and transmural myocardial scarry changes (group 2). The latter group was more difficult in terms of coronary bed affection, myocardial contractility and a greater proportion of patients with circulatory insufficiency, which dictated the type of anesthesia, myocardial protection and the surgical techniques in these patients. Aortocoronary shunting is shown to be quite justified and effective in patients with reduced left-ventricular ejection fraction, particularly so in group 1, yet it requires careful selection of patients, provision of adequate myocardial protection and maintenance of myocardial activity at all stages of the intervention.
Asunto(s)
Gasto Cardíaco Bajo/etiología , Puente de Arteria Coronaria/métodos , Enfermedad Coronaria/cirugía , Adulto , Anciano , Gasto Cardíaco Bajo/fisiopatología , Enfermedad Coronaria/fisiopatología , Paro Cardíaco Inducido , Ventrículos Cardíacos/fisiopatología , Humanos , Contrapulsador Intraaórtico , Cuidados Intraoperatorios , Masculino , Persona de Mediana Edad , Contracción MiocárdicaAsunto(s)
Miopía/cirugía , Esclerótica/cirugía , Adolescente , Adulto , Cartílago/trasplante , Femenino , Estudios de Seguimiento , Humanos , Masculino , Métodos , Factores de Tiempo , Pruebas de VisiónRESUMEN
A total of 128 patients with unstable angina pectoris (UAP) have been examined. Personal data of clinical examinations and the literature data enabled the authors to elaborate diagnostic criteria of UAP. Classification of UAP with consideration of its history, the clinical course of the disease and changes in the coronary arteries found with coronarography is offered. Almost half of patients with UAP begin to feel it while in perfect health. In 1/3 of cases only therapeutic treatment made the symptoms regress. It is established that UAP occurs mainly due to the changes in the system of left coronary artery. Very often stenosis of the main branch of this artery is observed.