SCINTIGRAPHY AFTER VARIOUS METHODS OF MYOCARDIAL REVASCULARIZATION

Background. This article presents a comprehensive assessment of the perfusion-functional state of the LV myocardium after direct and indirect revascularization methods at various times after surgery to evaluate the complex relationship between myocardial viability and the method of revascularization. Methods. The study included 214 patients who underwent myocardial revascularization in various ways. Gated-SPECT was performed before the operation, as well as 1 month, 6 months, 1 year, and 2 or more years after the operation. Results. The groups of patients after CABG and CABG+YurLeon had differences in SRS indicators two years after surgery: 6.58±5.37 (after CABG) and 1,57±1,12 (CABG+YurLeon)(p<0.05).The most significant changes in systolic thickening (WT) occurred in segments with an accumulation of 26-40%: 1.8±1.14 (CABG), 0.51±0.35 (CABG+YurLeon), 2.6±1.19 (PCI); and in segments 41-50%: 1.23±1.10 (CABG), 0.14±0.11 (CABG+YurLeon), 2.1±0.8 (PCI) (p<0.05).In the long-term period after revascularization, the total percentage of LV myocardial segments with “functional-perfusion mismatch” stood at: 11.08±10.69% of segments (CABG), 1.26±1.2% (CABG+YurLeon), 18.44±8.70% (PCI) (p<0.05). Conclusions. Comprehensive diagnostics of patients before surgery, including gated-SPECT, allow medical professionals to more effectively choose the method of revascularization and predict the nearest and separated results. Coronary bypass surgery together with the YurLeon technique of indirect myocardial revascularization in patients with severe diffuse lesions of the coronary artery shows more effective results than other methods of surgically treating IHD.

Download Full-text

Scintigraphy after Various Methods of Myocardial Revascularization

Cardiology Research and Reports ◽

10.31579/2692-9759/007 ◽

2020 ◽

Vol 2 (2) ◽

pp. 01-06

Author(s):

Yury Shevchenko

Keyword(s):

Gated Spect ◽

Bypass Surgery ◽

Myocardial Revascularization ◽

Coronary Bypass ◽

Total Percentage ◽

Systolic Thickening ◽

Indirect Revascularization ◽

Coronary Lesions ◽

One Year

Abstract. This article presents a comprehensive assessment of the perfusion-functional state of the LV myocardium after direct and indirect revascularization methods at various times after surgery to evaluate the complex relationship between myocardial viability and the method of revascularization. The research shows a significant advantage to using the YurLeon method of inducing extracardial revascularization of the myocardium in patients with diffuse coronary lesions. Aim. Comparative dynamic of scintigraphic indicators with various methods of revascularization. Materials and Methods.The study included 214 patients who underwent myocardial revascularization in various ways. Gated-SPECT was performed before the operation, as well as 1 month, 6 months, 1 year, and 2 or more years after the operation. Results.The groups of patients after CABG and CABG+YurLeon had differences in SRS indicators one year after surgery: 6.58±7.37 (after CABG) and 1.01±1.49 (CABG+YurLeon)(p<0.05).The most significant changes in systolic thickening (WT) occurred in segments with an accumulation of 26-40%: 1.78±1.84 (CABG), 0.51±0.85 (CABG+YurLeon), 2.6±1.19(PCI); and in segments 41-50%: 1.23±1.10 (CABG), 0.14±0.39 (CABG+YurLeon), 2.1±0.8 (PCI) (p<0.05).In the long-term period after revascularization, the total percentage of LV myocardial segments with "functional-perfusion mismatch" stood at: 11.08±11.69% of segments (CABG), 1.26±2.7% (CABG+YurLeon), 18.44±8.70% (PCI) (p<0.05). Conclusion. Comprehensive diagnostics of patients before surgery, including gated-SPECT, allow medical professionals to more effectively choose the method of revascularization and predict the nearest and separated results. Coronary bypass surgery together with the YurLeon technique of indirect myocardial revascularization in patients with severe diffuse lesions of the coronary artery shows more effective results than other methods of surgically treating IHD.

Download Full-text

Comparison of immediate and long term outcome of patients having emergent or deferred coronary bypass surgery following intravenous thrombolytic therapy for acute myocardial infarction

Journal of the American College of Cardiology ◽

10.1016/0735-1097(91)91951-a ◽

1991 ◽

Vol 17 (2) ◽

pp. A246 ◽

Cited By ~ 1

Author(s):

Dean J. Kereiakes ◽

Robert M. Califf ◽

Barry S. George ◽

Joseph Samaha ◽

Sharon Y. Young ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Thrombolytic Therapy ◽

Bypass Surgery ◽

Coronary Bypass ◽

Coronary Bypass Surgery ◽

Term Outcome ◽

Long Term Outcome

Download Full-text

Coronary-coronary bypass grafting: artery or vein?

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492320941689 ◽

2020 ◽

Vol 28 (6) ◽

pp. 316-321

Author(s):

Vladlen Bazylev ◽

Evgeny Rosseikin ◽

Dmitriy Tungusov ◽

Artur Mikulyak

Keyword(s):

Myocardial Revascularization ◽

Coronary Bypass ◽

Long Term Results ◽

Bypass Grafting ◽

Coronary Bypass Grafting ◽

Coronary Bypass Grafts ◽

Long Term Follow Up ◽

Observation Period

Background The method of coronary-coronary bypass grafting was described in 1987 but has not been widely used, and there are only a few studies that report good short-term and mid-term results as well as some individual cases of long-term follow-up. In our medical institution, we carried out an analysis of the long-term results of coronary-coronary bypass grafting, which are presented in this study. Methods This was a retrospective single-center study on 95 patients who underwent coronary-coronary bypass grafting as a supplement to the standard coronary bypass grafting procedure. All patients underwent angiographic assessment of the coronary bypass grafts during the long-term follow-up period. The observation period was up to 123 months. Angiographic assessment of 109 coronary-coronary grafts was carried out. Results Twelve (7.6%) arterial and 11 (19.3%) venous conduits were found to be occluded, and 8 (10.3%) arterial and 10 (31.3%) venous coronary-coronary grafts were occluded during the observation period. Conclusion Arterial coronary-coronary artery bypass grafting represents an alternative technique that allows complete myocardial revascularization.

Download Full-text

Long-term benefits of coronary bypass surgery: Are the gains for women less than for men?

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2003.10.007 ◽

2003 ◽

Vol 126 (6) ◽

pp. 1707-1711 ◽

Cited By ~ 23

Author(s):

Viola Vaccarino ◽

Colleen Gorman Koch

Keyword(s):

Bypass Surgery ◽

Coronary Bypass ◽

Coronary Bypass Surgery

Download Full-text

Does the use of an in situ or Y-configuration for bilateral internal thoracic arteries influence long-term survival, patency or repeat revascularization in coronary bypass surgery?

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivy195 ◽

2018 ◽

Vol 28 (2) ◽

pp. 222-226 ◽

Cited By ~ 4

Author(s):

Rory Kelleher ◽

Damian Gimpel ◽

David J McCormack ◽

Adam El-Gamel

Keyword(s):

Bypass Surgery ◽

Coronary Bypass ◽

Coronary Bypass Surgery ◽

Term Survival ◽

Long Term Survival ◽

Repeat Revascularization

Download Full-text

Peculiarities of diagnostics and treatment of patients with recurrent myocardial infarction

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2016-94-3-183-188 ◽

2016 ◽

Vol 94 (3) ◽

pp. 183-188

Author(s):

Georgy A. Gazaryan ◽

Ya. V. Taraseyeva ◽

L. G. Gazaryan ◽

S. G. Yevstratova ◽

F. M. Makaova ◽

...

Keyword(s):

Myocardial Infarction ◽

Conservative Therapy ◽

Myocardial Revascularization ◽

Coronary Bypass ◽

Reperfusion Therapy ◽

Lethal Outcome ◽

Risk Of Death ◽

Recurrent Myocardial Infarction ◽

Left Ventricle Dysfunction

The aim of the study was to evaluate the efficiency of invasive strategies for the treatment of 306 patients with recurrent myocardial infarction (IM) admitted to our clinic in 2003-2007. We compared the results of three approaches: various forms of transdermal coronary interventions (TDI) including delayed (24-72 hr) ones (n=30), surgical myocardial revascularization within 8-12 weeks after the onset of recurrent myocardial infarction (n=25), and conservative therapy (n=251). Overall cardiovascular lethality was estimated during 5 years in 101 patients. It was shown that recurrent myocardial infarction is a predictor of high risk of death associated, in the absence of reperfusion therapy, with high intra-hospital and long-term lethality. TDI soon after recurrent IM does not exclude possibility of its application in a later period. Various interventions including delayed ones markedly decrease the frequency of complications and lethal outcome that remains high in their absence. At the same time, severe lesions of the coronary bed in many patients with recurrent MI limit the possibility of using TDI and should be regarded as indications for planned surgical myocardial revascularization. Coronary bypass surgery after myocardial scarring prevents progress of left ventricle dysfunction, improves its contractility and increases life expectancy. Enhanced availability of reperfusion strategies in the form of TDI and/or delayed surgical myocardial revascularization opens up new possibilities for effective treatment of recurrent MI.

Download Full-text