The results of complex surgical treatment of patients with coronary heart disease

Abstract

Coronaryheart disease (CHD) remains one of the main causes of morbidity, early disability and mortality in the adultpopulation, despite significant achievements in the diagnosis and correction of coronary blood flow disorders. An undoubtedachievement at the present stage is the improvement of conservative and X-ray endovascular methods of treatment, but ithas led to an increase in the number of patients with diffuse coronary disorders. We have developed a method of combinedtreatmentof coronary heart disease through direct myocardial revascularization (CABG) in combination with the programYurLeonIII, which allows to improve the results in this group of patients.Aim. To compare the immediate and end resultsof combined surgery (CABG + YurLeon III) with isolated direct myocardial revascularization.Materialand methods.Thestudyincluded 730 patients diagnosed with coronary heart disease, exertional angina pectoris (stages III, IV), who underwentsurgicalrevascularizationof the myocardium in Pirogov National Medical and Surgical Center, Russian Federation. Therewere445 men (60.96%) and 285 (39.04%) women, aged 50 to 73. 580 patients underwent coronary bypass surgery (CABG).150 patients underwent coronary bypass surgery supplemented with indirect revascularization of YurLeon III (CABG +YurLeonIII). Patients underwent gated-SPECT, echocardiography, computer tomography, and quality of life evaluation with the use of SF-36 questionnaire.Results. At the intraoperative stage in the early postoperative period, there were no significantdifferencesin complication rates between t two groups (p > 0.05). 1 year after surgery, statistically significant differences inEF were noted: 55.10 ± 5.98% (after CABG + YurLeon III), 50.07 ± 6.54% (after CABG)(p < 0.05); perfusion defect:18.56 ±9.56%(after CABG) and 8.38 ± 5.79% (after CABG + YurLeon III) (p < 0.05); quality of life: increased in PF, BP, andRE indicators — by 39, 64, and 30 points (after CABG + YurLeon III); by 30, 29, and 26 points (after CABG) (p < 0.05).Conclusion.Coronarybypass surgery, supplemented with YurLeon III, is an effective and safe method of surgical treatment ofpatients with coronary heart disease, especially with diffuse disorders of the coronary arteries. It allows to additionally supplymyocardiumwith the blood.