Surgical Treatment Of Coronary Disease Research Articles

Academician Vladimir Ivanovich Burakovsky (1922–1994) (on the 100<sup>th</sup> anniversary of his birth)

Professor Vladimir Ivanovich Burakovsky was born on August 20, 1922 in Tiflis (Tbilisi). In 1940, Vladimir entered the Tbilisi Medical Institute. In 1947, V. I. Burakovsky was enrolled in a clinical residency at the Department of Faculty Surgery № 2 (since 1955 – Department of Surgery for Advanced Doctors № 1) Military Medical Academy named after S. M. Kirov in Leningrad. In the spring of 1960, Vladimir Ivanovich was accepted as a senior researcher at this Institute and appointed the head of the Department of Surgery of the heart and blood vessels in children. Vladimir Ivanovich was the author and co-author of more than 500 scientific papers, including 15 monographs: on the issues of pathophysiology, clinic, diagnosis and surgical treatment of congenital and acquired heart defects and major vessels, heart diseases in young children, complications after open heart surgery, surgery of complex congenital defects and coronary heart disease, heart defects with pulmonary hypertension, the use of hyperbaric oxygenation in cardiac surgery, surgical treatment of coronary disease, heart transplantation in experiment, history and philosophy of cardiac surgery. In 1970, «for the best scientific work on thoracic surgery», Vladimir Ivanovich was awarded the title of laureate of the S. I. Spasokukotsky Prize of the USSR Academy of Medical Sciences (together with B. A. Konstantinov). Academician Vladimir Ivanovich Burakovsky died on September 22, 1994 in Moscow and was buried at the Kuntsevo cemetery. The Institute of cardiac Surgery of the Federal State Budgetary Institution «A.N. Bakulev National Medical Research center of cardiovascular Surgery» (A. N. Bakulev NMRcVS) of the Ministry of Health of the Russian Federation bears his name, in which a bust of his creator is installed.

Current trends in surgical revascularization of multivessel coronary artery disease with arterial grafts.

It is well known that graft patency determines prognosis in coronary artery bypass grafting. Numerous reports over the past 20 years have documented superior patency and prognosis when multiple arterial grafts are used. The use of the left internal thoracic artery to graft the left anterior descending artery has been widely accepted as the gold standard for surgical treatment of coronary disease for over 40 years. A considerable body of evidence suggests that the right internal thoracic artery behaves in the same way. Radial artery grafts are being studied in several randomized trials, but observational studies suggest a performance comparing favorably with the saphenous vein. The right gastroepiploic artery has been recognized as a suitable and reliable conduit for coronary bypass surgery. However, the use of multiple other arterial grafts is performed in less than 10% of surgical procedures, probably because of perceptions of technical complexity, prolonged time for conduit harvesting, and increased perioperative complications. As a result, most patients with multivessel coronary artery disease do not benefit from extensive revascularization with arterial conduits. The aim of this review is to summarize the current evidence for the extensive use of arterial conduits in the revascularization of multivessel coronary artery disease.

The art of arterial revascularization-total arterial revascularization in patients with triple vessel coronary artery disease.

The use of the left internal thoracic artery to graft the left anterior descending artery has been widely accepted as the gold standard for surgical treatment of coronary disease for over 40 years. However the use of multiple other arterial grafts to support this has not been accepted readily, in spite of evidence of superiority over saphenous vein grafts, probably because of perceptions of technical complexity, time constraints for conduit harvesting and increased peri-operative complications. As a result, even today most patients with multivessel coronary artery disease do not receive the potential benefits of extensive or total arterial revascularization. We discuss here the use of contemporary techniques and grafts configurations to simplify this, and the safety and benefit data underpinning this practice. Current patency data confirm that a left internal thoracic artery graft performs well beyond 20 years, with over 80% freedom from failure, but accumulating data suggest that the right internal thoracic artery behaves in the same way. Radial artery grafts are being studied in several randomized trials, but observational studies already suggest a performance which compares favourably with saphenous vein. Total arterial revascularization is achievable in most patients with a small but acceptable increase in risk of sternal complications when certain defined subgroups are excluded.

Surgical treatment of coronary disease.

Surgical treatment of coronary disease.

Experimental study of the surgical treatment of coronary disease: Fauteux, M.: Surg., Gynec. & Obst. 71: 151, 1940

Experimental study of the surgical treatment of coronary disease: Fauteux, M.: Surg., Gynec. & Obst. 71: 151, 1940