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[The indications for surgical methods in treating diseases of the coronary arteries]
Insights
This study analyzed 236 surgeries for ischemic heart disease, including aorto-coronary shunt (ACS) and aneurysmectomy. The overall postoperative mortality rate was 6.5%, with selective coronarography being key for patient selection.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Cardiac Surgery Outcomes
Background:
- Ischemic heart disease (IHD) necessitates diverse surgical interventions.
- Aorto-coronary shunt (ACS) is a primary surgical approach for IHD.
- Combined procedures like ACS with aneurysmectomy or endarterectomy are employed.
Purpose of the Study:
- To report outcomes of various surgical procedures for ischemic heart disease.
- To detail patient selection criteria for aorto-coronary shunt (ACS) surgery.
- To evaluate the effectiveness of selective coronarography in guiding operative treatment.
Main Methods:
- Retrospective analysis of 236 surgical cases for ischemic heart disease.
- Procedures included aorto-coronary shunt (ACS), aneurysmectomy, endarterectomy, balloon angioplasty, and heart transplantation.
- Patient selection based on clinical assessment, ergometry, coronarography, ventriculography, end diastolic pressure, and ejection fraction.
Main Results:
- A total of 236 operations were performed across different IHD surgical categories.
- The overall postoperative mortality rate for all procedures was 6.5%.
- Selective coronarography data proved decisive in selecting patients for operative intervention.
Conclusions:
- Various surgical strategies are utilized for managing ischemic heart disease.
- A 6.5% postoperative mortality indicates the inherent risks associated with these complex cardiac procedures.
- Comprehensive diagnostic imaging, particularly selective coronarography, is crucial for optimizing patient selection and surgical outcomes in IHD.
Abstract:
Included in the study were 236 operations for ischemic heart disease (IHD) aorto-coronary shunt (ACS)--88 patients; ACS + aneurysmectomy--30; ACS + endarterectomy--12, aneurysmectomy--70; skin endocoronary balloon angioplasty--34, heart transplantation--2. The postoperative mortality was 6.5 per cent. Indications for ACS were specified on the basis of the patients state of well-being, the bicycle ergometry [correction of veloergometric] test, the coronarography and ventriculography, the end diastolic pressure and the ejection fraction. Decisive in selecting patients for operative treatment were the data of selective coronarography.