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Biomedical subjects

A M Abugov

Publications and source records attributed to A M Abugov.

At least 19 recordsLinked to original sources
PubMed1991

[Transcutaneous transcatheter use of laser recanalization of coronary arteries in patients with ischemic heart disease].

The paper discusses the potential possibility and effectiveness of X-ray endovascular laser recanalization (ELR) of the coronary arteries in order to treat coronary atherosclerosis in patients with coronary heart disease. The intervention was performed in 4 patients (into the anterior interventricular artery in 3 and into the right coronary artery in 1). In 3 of 4 cases, X-ray ELR proved to be successful, in one case the intervention failed due to technological reasons. Recanalization of a completely occluded segment of the coronary artery with a residual stenosis of no more than 40% was observed in two cases. Laser recanalization of profound local coronary stenosis was made in the mid-third of the vessel in one case. It can be stated that X-ray ELR of the coronary artery may extend the scope of X-ray surgical therapeutical tools of the treatment of coronary atherosclerosis. At the same time, accumulation of clinical experience and further improvement of laser and laser catheter engineering are essential in defining the value and possible scope for the application of this method.

Angioplasty, Laser↗
PubMed1991

[Association of aortocoronary bypass and intraoperative laser recanalization of the coronary arteries in ischemic heart disease. Initial clinical results].

The work discusses the results of intraoperative laser recanalization (LR) of the coronary arteries (CA). It is shown that the method facilitates increase of the degree of myocardial revascularization after a combined operation--aortocoronary shunting and intraoperative CA LR. The intervention was carried out on 10 patients, in 9 of them retrograde CA LR was conducted for recanalization of proximal affection of the CA and one patient underwent retrograde LR of a distally occurring stenosis of the anterior interventricular artery. Among the 10 interventions 7 were successful: in 5 patients the narrowed CA lumen was completely restored without residual stenosis, in 2 patients the stenosis reduced by 50-60% with a residual stenosis of no more than 30-40%. Perforation of the CA wall occurred in 2 cases and was repaired surgically. Still in another case an attempt to perform laser recanalization of the right CA failed because of technical reasons. Reocclusion of the recanalized CA segment was encountered in the late-term period in 2 of 4 patients. The conclusion may be drawn that CA LR is an effective auxiliary method in the formation of an aortocoronary shunt. The presence of diffuse, multiple lesions of the shunted CA and occlusion of the vascular lumen, affection of the distal arterial channel of the CA are the main indications for the use of intraoperative CA LR.

Adult↗
PubMed1990

[Recurrence of stenocardia after aortocoronary bypass and the possibility of repeated myocardial revascularization].

The causes of angina pectoris recurrences after aortocoronary bypass surgery have been studied. Indications for repeated myocardial revascularization and the possibilities for its performance have been analyzed. The long-term results of aortocoronary bypass surgery performed in 358 patients were evaluated at 30 months, on the average, after the operation. A gradual rise in the rate of angina recurrences was noted mostly within the first postoperative year. Repeated coronary angiography with bypass contrasting was done in 100 patients, 37 of whom presented angina recurrence. Impaired patency of the aortocoronary bypass was found to be the major cause of a recurrence (83.8%), this could be secondary to bypass thrombosis, fibrous hyperplasia of the graft intima, and atherosclerosis. Among other causes were incomplete revascularization of the myocardium and progression coronary atherosclerosis. All patients with pronounced angina pectoris were recommended repeated coronary angiography with bypass contrasting to specify indications for operation and possibilities for its performance. It was noted, that repeated revascularization may be hindered not by a factor responsible for the current recurrence, but primarily by the poor status of the distal portion of the diseased arteries due to diffuse atherosclerosis.

Adult↗
PubMed1989

[Computerized tomography in evaluating the function of aortocoronary shunts].

An examination was made of 38 patients undergone aortocoronary bypass surgery. Comparing the density of content in the aorta and shunt before and after bolus contrast in computerized tomography makes it possible to evaluate the patency of the aortocoronary shunt. A shunt patency coefficient (SPC) was proposed, which fitted the ratio of density differences in the shunt to those in the lumen of the ascending aorta before and after the injection of a contrast agent. SPC equal to 0.5 or more is indicative of a good patency of the aortocoronary shunt, but that being 0.3 or less suggests no or extremely poor function of the shunt. SPCs that are equal to 0.3-0.5 are transient indicators of its patency.

Adult↗
PubMed1988

[A method of quantitative evaluation of left-ventricular functional reserve in patients with heart aneurysm].

Twenty-four patients with postinfarction aneurysms of the heart and 9 patients with chest pains were investigated in order to assess the value of left-ventricular reserve parameters, proposed by the authors, i. e. the ratio between the percentage of change in ejection time and diastolic elasticity in the course of isometric stress and the increment at arterial blood pressure test. These parameters are shown to be more valuable for the assessment of left-ventricular function, as compared to conventional ventriculographic and intraventricular pressure parameters, measured at rest. The changes in ejection fraction and diastolic elasticity at isometric stress are a fairly reliable signal that the resection of heart aneurysm may be contraindicated.

Adult↗
PubMed1986

[Post-infarct cardiac aneurysm: clinical picture and contractile function of the myocardium in the remote period after surgical treatment].

Late results of surgery for chronic postinfarction aneurysm of the heart were reviewed in 48 patients. Comprehensive clinical and instrumental investigation demonstrated that aneurysm resection alone or in combination with aorto-coronary shunting or ventricular septoplasty resulted in clinical improvement in 60.4% of patients. However, surgery had basically no positive effect on left-ventricular myocardial contractility and pulmonary hemodynamics. The lack of positive changes in myocardial contractility is due to marked asynergy (akinesia) developing around the post-operative scar. The late postoperative outcome depends on both the type (akinetic or dyskinetic) of heart aneurysm, and timely referral for surgical treatment.

Adult↗
PubMed1985

[Myocardial function in the late period after an operation for aortocoronary shunting].

Thirty patients with coronary heart disease were examined prior to and 18.3 +/- 3 months after surgery, with 66% of the shunts proving to be patent. All patients were divided into 3 groups: group I--14 (47%) patients with patent shunts, group II--10 (33%) patients with partially patent shunts and group III--6 (20%) patients with occluded shunts. The group I and II patients displayed an improvement in the segmentary contractility and the integral function of the left ventricle as compared to the preoperative values. The group III patients showed a negative time-course of the segmentary and integral function of the left ventricle. In all cases of the impaired patency of the aortocoronary shunts there was progression of the atherosclerotic process in the basin of the shunted artery.

Adult↗
PubMed1984

[Contractile function of the myocardium of the left ventricle in patients with isolated lesions of the aortic valve].

Seventy-five patients (aged 17-53) with an isolated lesion to the aortal valve have been examined. The study of correlations between clinico-instrumental and angiocardiographic findings has shown that the isotonic overload of the left ventricle as against the isometric one causes more pronounced changes in the contractility of the left ventricular myocardium which are expressed in an increased heart volume, the development of electrocardiographic manifestations of the left ventricular overload, a considerable enhancement in the myocardium weight and in the residual and end diastolic volumes of the left ventricle. The value of the gradient of the systolic pressure in patients with isolated aortal ostium stenosis determines the intensity of myocardial alterations. In patients with aortal valve insufficiency, the value of the pulse pressure is directly correlated with the myocardial state. The contractile function of the left ventricular myocardium in patients with combined cardiac aortal disease is dependent on the predominance of isotonic or isometric overloads of the left ventricle.

Adolescent↗
PubMed1984

[Myocardial function in the period immediately after aortocoronary bypass].

Thirty patients with coronary heart disease were examined before and then 1.5 +/- 0.2 months after the operation of aortocoronary shunting. A total of 68% of the shunts proved patent. All patients were divided into 3 groups: group 1-14 (47%) patients with patent shunts, group 3-12 (40%) patients with partially patent shunts, group 3-4 (12%) patients with occluded shunts. The patients of the first two groups showed no changes in either the segmentary contractility of the left ventricular wall or in the time-course of the ejection fraction and left ventricular volumes. The patients of group 3 demonstrated the deterioration of both hemodynamic indices and parameters characterizing the segmentary contractility of the left ventricular wall which was caused by thrombosis of the aortocoronary shunt resulting in the development of ischemia or myocardial infarction in the zone of the shunted coronary artery.

Adult↗