scholarly journals DIAGNOSTICS AND INTENSIVE CARE OF HEART FAILURE IN PATIENTS WHO UNDERWENT CORONARY ARTERY BYPASS GRAFT SURGERY WITH ARTIFICIAL CIRCULATION

Author(s):  
V.I. Cherniy ◽  
Y.V. Kurylenko

Abstract. Introduction. Coronary heart disease, the complexity of the surgery conducted, inflammatory reaction to extracorporeal circulation and the need for perioperative anticoagulation influence perioperative state of hemodynamics during the surgical revascularization of a myocardium in patients with coronary heart disease. The aim. To improve the results of treatment of cardiac surgery patients with heart failure who underwent surgery, namely, coronary artery bypass grafting using extracorporeal circulation by improving methods of diagnosing heart failure. Materials and methods. 100 cardiac surgery patients with coronary heart disease were operated on at State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. In all the cases, coronary artery bypass grafting was performed using artificial circulation. In patients of group 1 (40 patients) in the postoperative period, the correction of hemodynamic disorders was performed according to the standard protocol. In group 2 (60 patients) - a differentiated approach to the correction of hemodynamic disorders was used. Results. It was found that in group 2 for stabilization of hemodynamics, oxygen status, microcirculation, smaller doses of sympathomimetics and shorter duration of their use, P <0.05 than in 1 were applied. Conclusions. The results of the studies indicate the possibility of using the method of phasography, in particular, the analysis of symmetry of the T wave, as a marker of ischemic changes in the myocardium in cardiac patients who underwent coronary artery bypass grafting using artificial circulation. The obtained data show that the developed algorithm of perioperative management of cardiac surgery patients with heart failure makes it possible to significantly accelerate the rehabilitation of cardiac surgery patients, increase patient comfort and reduce the length of their hospitalization. The possibility of using phasography for monitoring of myocardial condition in patients undergoing coronary artery bypass surgery has been investigated.

2021 ◽  
Vol 7 (5) ◽  
pp. 1203-1213
Author(s):  
Shi Qiu ◽  
Jinhui Sun

This study was designed to evaluate the clinical significance of simultaneous heart valve surgery and coronary artery bypass grafting for patients with valvular heart disease complicated by coronary heart disease and its influence on their prognosis. A total of 121 patients with valvular heart disease complicated by coronary heart disease who were surgically treated in our hospital from January 2013 to March 2017 were selected. The observation group (OG) (64 patients) underwent simultaneous valvular heart surgery and coronary artery bypass grafting. The control group (CG) (57 patients) underwent non-synchronous heart valve surgery and coronary artery bypass grafting. The operation, hospitalization, occurrence of adverse events and changes of cardiac function indexes of patients from the two groups were compared, and the factors affecting their prognosis were confirmed in multivariate analysis. The ventilator application time, postoperative ICU monitoring time, postoperative general ward time and total incidence of adverse events in the OG were lower than those in the CG (P<0.05). After treatment, the cardiothoracic ratio, left ventricular end-diastolic volume and BNP content in the two groups were markedly higher than before treatment, and the increase in the OG was more obvious (P<0.05); the left ventricular ejection fraction in both groups was markedly lower than that before treatment (P<0.05), and the decrease in the OG was more obvious (P<0.05). Multivariate analysis showed that hypertension, treatment methods, course of disease and age were independent risk factors affecting the prognosis of patients with valvular heart disease complicated by coronary heart disease. Simultaneous heart valve surgery and coronary artery bypass grafting can reduce the occurrence of adverse events and improve cardiac function indexes, which is worthy of clinical application. Hypertension, treatment methods, course of disease and age are independent risk factors affecting the prognosis of those patients.


Author(s):  
E. A. Sergeev ◽  
M. E. Shmelev ◽  
B. I. Geltser ◽  
V. N. Kotelnikov

Aim. Evaluation of nanostructural and micromechanical characteristics of erythrocytes and their relationship with the parameters of oxygen transport in patients with ischemic heart disease (IHD) after coronary artery bypass grafting (CABG) under artificial circulation (AC).Materials and methods. The study involved 30 men with IHD aged 53 to 67 years with a median of 63 years, who underwent planned CABG with AC at the clinic of the Far Eastern Federal University. Blood sampling from patients was carried out before the AC and one day after it from a venous catheter located in the right atrium. Erythrocytes were scanned using a Bioscope Catalyst atomic force microscope (AFM) (Bruker, USA) in combination with an Axiovert 200 inverted microscope (Zeiss, Germany). The micromechanical properties of cell membranes were investigated with the PFQNM-LC-A-CAL cantilevers. The following were recorded: the diameter of erythrocytes, the height of their side, area, volume, membrane rigidity, strength of its adhesion, Young's modulus, elastic deformation. To assess oxygen transport, the oxygen delivery index (DO2I), consumption (VO2I), and extraction ratio (O2ER) were calculated.Results. In one day after CABG, a decrease in DO2I, VO2I, and O2ER was recorded by 14%, 33%, and 16%, respectively, which indicated a limitation in the gas transport function of the blood. Analysis of the AFM characteristics of erythrocytes showed an increase in their area by 35%, in diameter by 6%, in volume by 19%, and the height of the side by 5 times. At the same time, multidirectional changes in the micromechanical properties of erythrocyte membranes were noted: Young's modulus and stiffness decreased by 3.2 and 2 times, respectively; the adhesion force increased by 2.7 times, and the elastic deformation – by 2.2 times. Correlation analysis showed the presence of reliable relationships between indicators of oxygen transport and biomechanical parameters of erythrocyte membranes.Conclusion. A comprehensive analysis of the nanostructural parameters of erythrocytes and oxygen transport expands the understanding of the pathophysiological mechanisms of postperfusion disorders in patients with coronary artery disease after CABG under conditions of cardiopulmonary bypass.


2004 ◽  
Vol 9 (3) ◽  
Author(s):  
Nafisa Cassimjee ◽  
Caroline L Couzens ◽  
Frans J Smith ◽  
Claire Wagner

People with coronary heart disease have recourse to a palliative intervention such as Coronary Artery Bypass Grafting (CABG). Opsomming Persone met ‘n koronêre hartsiekte is soms genoodsaak om ‘n hartomleiding (CABG), wat ‘n tydelike intervensie ter verligting is, te ondergaan. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.


2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Xiaoyu Zhou ◽  
Jiong Guo ◽  
Liliang Shu ◽  
Jing Xu

<p>Objective: To analyze and explore the clinical observation of coronary artery disease with coronary heart disease and coronary heart disease (CHD) undergoing coronary artery bypass grafting. Methods: From December 2015 to December 2016, 80 patients with coronary heart disease and heart valve were randomly divided into two groups: observation group and control group (40 cases). The observation group was treated with coronary artery bypass grafting combined with simultaneous heart valve replacement. The control group was treated with coronary stent implantation and non-synchronous valve replacement. The improvement of postoperative cardiac function, postoperative hospitalization, adverse events and bridge patency were compared between the two groups. Results: The improvement of cardiac function and the incidence of adverse events were significantly better in the observation group than in the control group (P &lt;0.05). The time of hospitalization and the time of ventilator were significantly shorter than those of the control group (P &lt;0.05). The patency rate of the bridge was significantly higher than that of the control group (P &lt;0.05). Conclusion: Coronary artery bypass grafting combined with heart valve replacement in patients with coronary heart disease complicated with valvular heart disease can achieve significant curative effect, which is more ideal and safer than coronary artery bypass surgery combined with non-synchronous valve replacement.</p>


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