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Biomedical subjects

R A Azovtsev

Publications and source records attributed to R A Azovtsev.

16 recordsLinked to original sources

[The dynamics of the coronary bed state in patients with ischemic heart disease after surgical correction of dyslipoproteidemia].

The investigation included 85 ischemic heart disease patients with the coexistent dyslipoproteidemia. In 39 of the patients the operation of partial shunting was performed for correction of the impaired lipid metabolism. It was found that the partial ileoshunting was an effective method of correction of dyslipoproteidemia. The effect of the operation was due to lowering the total cholesterol level in blood (at an average by 25.6%) and elevation of the HDL level (at an average by 19.6%). The results of the following angiographic examinations have shown a clear effect of the inhibition of progressing coronary atherosclerosis in patients who underwent surgical correction of dyslipoproteidemia that allows the partial ileoshunting to be considered as an effective method of the secondary prophylactics of atherosclerosis. The HDL level is the main marker of the dynamics of the atherosclerotic process in the coronary arteries.

Adult↗

[Features of angioplasty and stenting in atherosclerotic stenting of coronary artery occlusions].

The authors analyze results of coronary angioplasty in 257 patients with ischemic heart disease who had occlusions of the coronary arteries. Clinical, angiographic and other findings showing the duration of having the occlusions of the coronary artery are described in detail. The details of the steps of the technique of the endovascular intervention are considered including the most difficult step--passing through the occluded portion of the artery. Great attention is given by the authors to the criteria of using the correct instruments (conducting catheter, conductors, balloon-catheters) during the operation. Good results were obtained in 80.2% of the patients after coronary angioplasty. Stenting of the coronary arteries was performed in 65 patients (25.3%).

Adult↗

[Complications after angioplasty and stenting of coronary arteries in ischemic heart disease patients].

The authors have made an analysis of most frequent complications of angioplasty and stenting of coronary arteries in 1900 patients with various forms of ischemic heart disease. The mechanisms, pathomorphology, angiographic and clinical manifestations of such complications as dissection of the coronary artery intima, acute occlusion of the coronary artery, "no-reflow" syndrome, perforation and rupture of the coronary artery, acute thrombosis in the stent area and other complications are considered in detail. Special medical strategy, both therapeutic and surgical, is proposed for each case. The authors propose a number of prophylactic measures allowing to avoid the complications described or to minimize them. Intraoperative lethality in this group of patients was 0.5% (10 patients), during the first week after endovascular intervention 26 patients died (1.4%).

Adult↗

[Angioplasty for atherosclerotic lesions of the left main coronary artery].

The authors analyze results of coronary angioplasty and stenting in patients with ischemic heart disease with a lesion of the left main coronary artery. Injuries of the left main coronary artery took place in 14 (0.74%) out of 1900 patients after coronary angioplasty. A detailed analysis of the operation technique, indications and contraindications for endovascular intervention is given. The results of balloon angioplasty with and without the following stenting are compared.

Adult↗

[Surgical treatment of ischemic heart disease using internal thoracic artery and partial ileal bypass].

The authors recommend complex two-stage treatment of ischemic heart disease, including a reconstructive operation on the coronary arteries and an operation for correcting the disturbed plasma lipid spectrum (partial ileal bypass). The results of operative treatment of 150 patients with the use of the internal thoracic artery were studied. The authors emphasize the advantages of this operation over one using an autovein graft. Complex operative treatment was conducted in the clinic in 60 patients with a good clinical effect. The authors also recommend operation for partial ileal bypass as an independent intervention in dyslipoproteinemia and diffuse affection of the coronary arteries.

Adult↗

[Internal thoracic artery in coronary surgery].

The authors emphasize advantages of using the internal thoracic artery for mammary-coronary shunts in patients with ischemic heart disease. 257 operations have been performed in the clinic since 1964. Among them there were operations of mammary-coronary anastomosis (after V. I. Kolesov) and mammary-coronary shunts. Long-term results were followed-up which evidence high effectiveness of operative treatment. In 109 patients control angiographic examinations were fulfilled at different terms (up to 12 years). Patency of mammary-coronary shunts was 83.5% as compared with ACSh where it was about 63%.

Coronary Disease↗

[Surgical treatment of chronic ischemic heart disease].

The authors suggest a new complex approach to the surgical treatment of ischemic heart disease. Operation of coronary shunting for the restoration of the coronary blood flow, operation of partial ileoshunting for correction of hyperlipoproteinemia, plexotomy for removal of the vasospastic component. The sequence of the operations may vary, each one can also be undertaken independently. The operations were conducted on 315 patients. The follow-up period is up to 8 years. Patency of the mammary-coronary shunts was 93.5%, of autologous veins shunt--65%. Disappearance of the signs of coronary spasm++ and stable normalization of the lipid spectrum are noted.

Adult↗

[Function of the myocardium after revascularization and the patency of coronary shunts].

The article analyzes the contractive function of the myocardium in 149 patients after operation of a single aortocoronary shunt (25 patients), mammaro-coronary shunts with mechanical anastomosis (109 patients) and with manual distal anastomosis (15 patients). Patency of the aorto-coronary shunts was 72%, mammaro-coronary shunts with direct distal anastomosis - 83.5%, with the end-to-side anastomosis - 88.8%. The myocardium function was improved in patients with patent shunts. In patients with incompetent shunts further deterioration of the contractive function of the left ventricle myocardium was noted. It was pointed out that the development of myocardium infarction in the zone of the coronary artery operated upon is not always accounted for by a shunt thrombosis.

Adult↗

[The contractile function of the myocardium in patients with ischemic heart disease after the mammary-coronary artery shunting].

Under investigation there were 91 patients subjected to operations of mammary-coronary shunts with putting end-to-end anastomoses between the left internal thoracic artery and the anterior interventricular artery. Control examinations were performed within the terms from 3 weeks to 7 years. The patency of the shunt was established in 85 of 91 patients. The author considers that the function of the left ventricle myocardium was considerably improved in patients with passable shunts (the patients after myocardium infarction).

Adult↗