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

Coronary heart disease (CHD) remains one of the main causes of morbidity, early disability and mortality in the adult population, despite significant achievements in the diagnosis and correction of coronary blood flow disorders. An undoubted achievement at the present stage is the improvement of conservative and X-ray endovascular methods of treatment, but it has led to an increase in the number of patients with diffuse coronary disorders. We have developed a method of combined treatment of coronary heart disease through direct myocardial revascularization (CABG) in combination with the program YurLeon III, which allows to improve the results in this group of patients.

Aim. To compare the immediate and end results of combined surgery (CABG + YurLeon III) with isolated direct myocardial revascularization.

Material and methods. The study included 730 patients diagnosed with coronary heart disease, exertional angina pectoris (stages III, IV), who underwent surgical revascularization of the myocardium in Pirogov National Medical and Surgical Center, Russian Federation. There were 445 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 + YurLeon III). 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 significant differences in complication rates between t two groups (p > 0.05). 1 year after surgery, statistically significant differences in EF 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, and RE indicators — by 39, 64, and 30 points (after CABG + YurLeon III); by 30, 29, and 26 points (after CABG) (p < 0.05).

Conclusion. Coronary bypass surgery, supplemented with YurLeon III, is an effective and safe method of surgical treatment of patients with coronary heart disease, especially with diffuse disorders of the coronary arteries. It allows to additionally supply myocardium with the blood.

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