Direct myocardial revascularization after 6, 12 and 24 hours of acute coronary syndrome
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OBJECTIVE To evaluate the results of direct myocardial revascularization within 72 hours after manifestation of acute coronary syndrome. MATERIAL AND METHODS A retrospective study included 48 (0.47%) out of 10 193 patients with coronary artery disease who underwent coronary artery bypass grafting for the period 2011-2019. Study patients underwent urgent direct myocardial revascularization. SYNTAX Score >22 points was observed in all cases. All patients were divided into 3 groups depending on timing of surgery: 26 patients - within 6 hours after admission, 15 patients - within 6 - 24 hours, 7 patients - within 24-72 hours. RESULTS Level of myocardial damage markers was similar after 1 and 2 days (p>0.05). In the 1st group, 1 (3.84%) patient died in hospital, 5 (19.2%) patients - within 1 year after surgery. In the 2nd group, these values were 1 (6.6%) and 0, respectively. There was no mortality in the 3rd group (p>0.05). Overall 5-year survival was 100%. CONCLUSION Early active open revascularization is advisable in patients with ACS and clear indications for surgery.Keywords:
Myocardial Revascularization
Objective:To inquire and expound the newest development of revascularization treatment in coronary heart disease.Method:Reading the literature about revascularization and then summarizing them.Result:Clinical study and experimental study making clear that revascularization is a complicated process,its mechanism concluding a lot of fields.It effects a good care to myocardial ischemia.Conclusion:Therapeutic angiogenesis will be a new way to clinical coronary heart disease. [
Myocardial Revascularization
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Identifying viable myocardium with FDG-PET imaging identified patients with left ventricular (LV) dysfunction who benefited from revascularization and had improved survival. Contrast-enhanced magnetic resonance imaging also has been shown to identify viable myocardium. Baseline ejection fraction, magnitude of myocardial scarring, degree of LV remodeling, and time to revascularization are inversely related to functional recovery after revascularization.
Myocardial Revascularization
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Myocardial Revascularization
Stable angina
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Recent studies on the role of viable myocardium in revascularization are hot spots. The definition of viable myocardium, multimodality imaging in the assessment of myocardial viability, Meta analyses related to the value of viable myocardium in revascularization, prospective randomized trials, and factors affecting the prognosis of patients after revascularization are reviewed in this article.
Key words:
Myocardial ischemia; Myocardial stunning; Myocardial reperfusion; Trends
Myocardial Revascularization
Hibernating myocardium
Myocardial Stunning
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Myocardial revascularization has been carried out by us in 67 patients 70 years of age or older. Advanced coronary artery disease was found at angiography in more than two thirds of the patients. The postoperative morbidity and mortality compare very favorably with those in younger patients. The early and late mortality in the 67 patients was 4.5 percent and 6.0 percent, respectively. Fifty-seven survivors have been followed an average of 21 months; for most patients there has been a pronounced improvement in clinical classification. Properly selected, patients of advanced age can undergo successful revascularization surgical procedures. The adequacy of function of the left ventricle, proper timing of the surgical operation and an aggressive yet realistic approach seem to be major determinants for a good result.
Myocardial Revascularization
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Before the advent of CABG, standardized in the late '60s by Favaloro and Effler, patients with myocardial ischemia underwent indirect and heterogeneous off-pump methods of myocardial revascularization.Indirect revascularization, such as periaortic nerve plexus interruption, Vineberg operation, Sen procedure and, less remotely, TMR Laser and stem cell transplantation, represented some of the ways to achieve myocardial revascularization. Nowadays, direct coronary revascularization is the only established technique and may be performed either on-pump or off-pump.The comparison of off-pump and on-pump myocardial revascularization paved the way to an endless debate between the advantages and disadvantages of each technique. In this article, we review the old and current off-pump approaches of surgical myocardial revascularization.
Myocardial Revascularization
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Myocardial Revascularization
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Objective: Off-pump myocardial revascularization using bilateral mammary artery (BIMA) is a promising concept in cardiac surgery during the last years. Beside proven benefits toward off-pump surgery, there is an ongoing debate, whether single mammary artery revascularization (SIMA) is superior to the BIMA revascularization in the short and long term course.
Mammary artery
Myocardial Revascularization
Single Center
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