Surgical tactics in occlusive lesions of the brachiocephalic and coronary arteries

: Surgical management of combined arterial occlusions is a difficult problem. Combined lesions of the coronary arteries and brachiocephalic trunk are marked by significant mutual aggravation. The authors examined 48 patients with this pathological condition in the last 4 years, 32 of them underwent restorative surgical interventions. The direct effect was positive in 87% of patients. Four patients died after the operation. Comparative evaluation of the late-term results was carried out by the actuarial method. The authors believe a stage-by-stage character of the intervention to be expedient, except for cases of one-stage critical ischemia carried out simultaneously in two arterial channels and the possibility of simultaneous reconstruction of the sternotomy approach.