Assuntos
Doenças Cardiovasculares , Fibrinolíticos , Período Perioperatório/métodos , Hemorragia Pós-Operatória/etiologia , Trombose/prevenção & controle , Doenças Cardiovasculares/classificação , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/cirurgia , Fibrinolíticos/administração & dosagem , Fibrinolíticos/efeitos adversos , Fibrinolíticos/uso terapêutico , Humanos , Período Perioperatório/normas , Hemorragia Pós-Operatória/prevenção & controle , Guias de Prática Clínica como Assunto , Fatores de Risco , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/métodos , Fatores de TempoRESUMO
Changes in hemodynamics and blood oxygen transport function were studied during coronary bypass surgery (CBS) on the working heart under anesthesia with propofol and fentanyl. In patients operated on the working heart, the course of the basic stage of an operation was characterized by a moderate reduction in cardiac index and stroke volume due to the cardiac changes and immobilization, which resulted in cardiac compression and venous return deterioration. These impairments did not lead to worse oxygen-transportfunction and they were completely eliminated in the rehabilitative period. Analyzing the results of studies of troponin-T and creatinine kinase-MB showed that the procedure of coronary bypass surgery without using EKK had a less damaging effect on the myocardium. Analyzing the course of an early postoperative period indicated that the use of perfusionless technology substantially reduced needs for inotropic support, the time of artificial ventilation, and the length of stay at an intensive care unit.
Assuntos
Ponte de Artéria Coronária , Coração/fisiopatologia , Idoso , Ponte Cardiopulmonar , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Consumo de OxigênioRESUMO
The authors discuss results of more than 300 operations of the aorto-coronary bypass using the radial artery as a shunt. An analysis of the initial state of the patients, the intraoperative, early postoperative and intrahospital periods was made. Special attention was given to specific features of the isolating and using the radial artery grafts. Specific complications resulting from the application of them were analyzed and recommendations are given for prophylactics of such complications. The experiences with using the radial arteries allow to recommend it in revascularization of the myocardium. It is one of the ways of improving immediate and long-term results of operations on patients with ischemic heart disease.
Assuntos
Ponte de Artéria Coronária/métodos , Artéria Radial/transplante , Adulto , Idoso , Ponte de Artéria Coronária/mortalidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/complicações , Isquemia Miocárdica/cirurgia , Complicações Pós-Operatórias , Fatores de TempoRESUMO
A comparative analysis of effectiveness of anti-ischemic defense of the myocardium performed in operations on the heart in 128 patients has shown that use of ion-balanced solutions is preferential since it allows reducing intrahospital lethality related with acute cardiac insufficiency from 13.3% to 6.3%.