Authors
Borshchev G.G., Batrashov V.A., Zemlyanov A.V., Marynich A.A.
St. George thoracic and cardiovascular surgery clinic Pirogov National Medical and Surgical Center, Moscow
Abstract
This study is based on the results of a retrospective analysis of simultaneous and staged surgical treatment of patients with combined atherosclerotic lesions of the coronary arteries and pathological convolutions of the internal carotid arteries. When comparing the two groups of patients, depending on postoperative complications, it was revealed that the probability of developing delirium, bleeding and cerebral ischemia in the group of staged operations was lower compared to the group of simultaneous operations (by 39.4% (p<0.05); by 33.5% (p>0.05) and by 19.9% (p>0.05), respectively). The probability of myocardial infarction in the group of staged operations was 17.2% higher compared to the group of simultaneous surgery (p>0.05).
According to the results of the study, it was concluded that patients with combined hemodynamically significant atherosclerotic lesions of the coronary arteries and pathological hemodynamically significant tortuosity of the internal carotid arteries, the method of choice is to perform staged revascularization. The first stage is recommended to perform aorto-coronary bypass surgery followed by resection of the pathological tortuosity of the internal carotid artery.
Keywords: simultaneous surgery, staged operations, aorto-coronary bypass surgery, resection of pathological tortuosity.
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