[Modern approaches to diagnostics and surgical correction of brachiocephalic arteries disorders in patients with ischemic heart disease].

The main causes of morbidity in Russia are ischemic heart and cerebrovascular disease. The mortality rate of these conditions accounts for almost 50% of all the lethality causes of the Russian population. The frequency of associated coronary and brachiocephalic arteries disorders varies from 18 to 54%. The complex evaluation of the anatomical and functional features of the disorder, as well as of the perfusion and functional heart and brain reserves allows to choose the appropriate methods of surgical treatment of patients with associated coronary and carotid disorders and to decrease the risk of intra- and postoperative cerebral and cardiac complications. The modern approaches of myocardium and cerebral revascularization enable to safely and effectively eliminate the myocardial and cerebral ischemia, to significantly decrease the risk of myocardial infarction and stroke development and to ensure the long ability to work among this group of patients. Over 500 patients with ischemic heart disease and associated brachiocephalic arteries disorders have been operated at the A.N. Bakoulev Scientific Centre for Cardiovascular Surgery for the last 5 years. The results of these operations are comparable to the ones of the leading European clinics.

[Changes in cognitive functions in patients with occlusive lesions of brachiocephalic arteries after reconstructive surgery on carotid arteries].

Seventy-six patients after the reconstructive surgery on carotid arteries underwent neuropsychological testing with the MMSE, the FAB, the Clock Drawing Test at baseline and 8-10 days and 3 months after the surgery. Patients were stratified into 3 groups: 20 patients with predominant lesions of one internal carotid artery (group 1), 22 patients with bilateral carotid stenosis (group 2) and 34 patients with the combination of lesions of carotid and vertebrobasilar system (group 3). The association between the rate of spreading of atherosclerotic processes in cerebral vessels and cognitive disorders was shown. The positive effect of reconstructive surgery on cognitive functions of patients was confirmed.