DOI: 10.25881/BPNMSC.2021.68.32.002

Authors

Shevchenko Yu.L., Zainiddinov F.A., Borshchev G.G., Belyanin A.O., Ulbashev D.S.

St. George thoracic and cardiovascular surgery clinic Pirogov National Medical and Surgical Center, Moscow

Abstract

In our time, the search for new methods of treatment of patients with coronary heart disease (CHD), especially patients with diffuse lesions of the coronary bed, in which complete revascularization of the myocardium is impossible, remains relevant. This article presents comparative data on coronarography, myocardial contractility and gated-SPECT data in patients after direct myocardial revascularization and coronary bypass grafting, supplemented by the YurLeon III.

Materials and methods. We analyzed results of coronarography, gated-SPECT, and echocardiography of 202 patients who were treated in the Department of Cardiovascular Surgery of the N. I. Pirogov National Medical Center in the period from 2017 to 2020 with a diagnosis of CHD. There are two groups of patients were compared: group 1 — after isolated coronary artery bypass grafting (CABG) -150 patients; group 2 — after CABG supplemented with indirect myocardial revascularization YurLeon III (CABG+YurLeon III) — 52 patients.

Results. In the period from 12 to 24 months, EF LV indicators: 57.10±6.19% (CABG+YurLeon III), 50.11±6.33% (CABG) (p<0.05). After 1 year, there is perfusion defect:10.12±5.21% (CABG+YurLeon III), 17.99±8.37% (CABG) (p<0.05). In the second group, the number of segments of mismatch between the occluded autovenous bypass and normal myocardial perfusion in this zone statistically significantly less (p<0.05). In the first group in the long term, acute myocardial infarction (AMI) associated with autovenous bypass occlusion was approximately 10% (17 out of 150 patients), in the CABG+ YurLeonIII group — 3.8% (2 out of 52 patients).

Conclusion. The method of stimulation of extracardial angiogenesis YurLeon III, which complements coronary bypass surgery, is a safe and effective method of surgical treatment of patients with coronary heart disease.

Keywords: ischemic heart disease, bypass, coronarography, gated-SPECT, indirect revascularization, coronary bypass surgery, YurLeon.

References

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For citation

Shevchenko Yu.L., Zainiddinov F.A., Borshchev G.G., Belyanin A.O., Ulbashev D.S. The results of coronarography and gated-spect in patients with coronary heart disease after myocardial revascularization. Bulletin of Pirogov National Medical & Surgical Center. 2021;16(1):11-16. (In Russ.) https://doi.org/10.25881/BPNMSC.2021.68.32.002