[Prediction of cardiac complications during operations on the brachiocephalic arteries]

The development of myocardial or brain ischemia is a major hazard to patients operated on the brachiocephalic arteries. The purpose of the present study was to reveal a risk factor or its group of factors whose correction would improve the prediction of surgical interventions as a whole. A preliminary study included 105 patients (among them there were males (80%), whose mean age was 60 +/- 0.77 years; females (20%) whose mean age was 64 +/- 1.38 years). It has shown that a significant individual impact on the occurrence of cardiac complications was produced by the following factors: the severity of angina pectoris (p = 0.01); diabetes mellitus (p = 0.01); transesophageal stimulation test (the presence of a low or moderate coronary circulatory reserve) (p = 0.02), hypertensive disease (p = 0.04). The likelihood of development of cardiological complications drastically increases with a rise in the number of significant risk factors of concomitant diseases. Their determining risk factors are hypertensive disease and postoperative arterial hypertension, which, in combination with other risk factors, provokes cardiac complications in the postoperative period. In the patients with the high predictable likelihood of cardiac complications during operations on the brachiocephalic arteries, the priority task is to stabilize blood pressure when the patients are prepared for surgery and to prevent unstable hemodynamics in the postoperative period.