RESUMEN
Intracoronary shunts (IS) are devices for maintaining distal coronary blood flow when placing anastomoses with coronary arteries. The use of IS ensures functional and electrical stability of myocardium during its revascularization on the working heart. There are reports of endothelial damage by IS leading to dysfunction of coronary shunts. This study compares 208 patients with and without IS. Results of surgery were evaluated during hospitalization period. The groups were matched for initial clinical and instrumental characteristics and the number of shunt placements. It was shown that minimally invasive myocardial revascularization with the use of IS when placing distal anastomoses has a number of advantages over similar surgery without IS, viz. smaller degree of intraoperative myocardial lesion, blood loss, and frequency of postoperative complications along with enhanced stability of intraoperative hemodynamics.
Asunto(s)
Enfermedad de la Arteria Coronaria/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Revascularización Miocárdica/instrumentación , Stents , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Estudios Retrospectivos , Resultado del TratamientoAsunto(s)
Trastornos Cerebrovasculares/epidemiología , Puente de Arteria Coronaria/efectos adversos , Complicaciones Posoperatorias , Enfermedad Aguda , Trastornos Cerebrovasculares/etiología , Trastornos Cerebrovasculares/prevención & control , Circulación Extracorporea , Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos , Isquemia Miocárdica/cirugía , Revascularización Miocárdica/métodos , Fármacos Neuroprotectores/administración & dosificación , Fármacos Neuroprotectores/uso terapéutico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Pronóstico , Factores de Riesgo , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/prevención & control , Factores de TiempoAsunto(s)
Remodelación Ventricular , Antagonistas Adrenérgicos beta/farmacología , Angioplastia Coronaria con Balón , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Bloqueadores de los Canales de Calcio/farmacología , Procedimientos Quirúrgicos Cardíacos , Cardiomegalia/fisiopatología , Carnitina/farmacología , Diástole/fisiología , Ecocardiografía de Estrés , Aneurisma Cardíaco/fisiopatología , Insuficiencia Cardíaca/fisiopatología , Humanos , Imagen por Resonancia Magnética , Infarto del Miocardio/complicaciones , Infarto del Miocardio/patología , Infarto del Miocardio/fisiopatología , Aturdimiento Miocárdico , Pronóstico , Ensayos Clínicos Controlados Aleatorios como Asunto , Sístole/fisiología , Factores de Tiempo , Tomografía Computarizada de Emisión , Disfunción Ventricular Izquierda/fisiopatología , Remodelación Ventricular/efectos de los fármacos , Remodelación Ventricular/fisiologíaRESUMEN
Sixteen patients with the X syndrome underwent thallium-201 myocardial scintigraphy. Eleven patients with one-coronary artery disease served as a control group. During bicycle ergometry all the 16 patients showed various degrees of local myocardial perfusion impairments. The foci were located in the basins of various coronary vessels. Impaired myocardial perfusion in patients with the X syndrome was similar to that in patients with moderate, but hemodynamically significant stenosis of a coronary artery. At the same time the impairments were significantly less pronounced than in those with critical stenosis of a coronary artery. Thus, patients with the X syndrome have not only clinical signs of coronary heart disease (anginal episodes), but they also have marked myocardial perfusion impairments during exercise.