PubMed Health⌕ Search

Biomedical subjects

R Iliev

Publications and source records attributed to R Iliev.

5 recordsLinked to original sources
PubMed2004

[Multiple coronary endarteriectomy in patients with diffusial coronary disease].

UNLABELLED: In recent years the profile of patients with CAD is continuously changing, often with previous operation or stenting. Multiple coronary endarterectomies have been utilized as an adjunct to CABG in this select group of patients to achieve complete revascularization because of the diffuse CAD. METHODS: Between January 1997 and December 2001 eighty eight consecutive patients undergoing first time CABG with more than two CE were compared with a control group of 967 patients undergoing CABG without CE. RESULTS: More than 9% of the CABG patients need two or more endarterectomies, with involvement of the RCA in 96% and LAD in 59%. The extended time of aortic clamping and the higher rate of perioperative MI lead to higher mortality in Group 1 without significant difference between groups. The 5 years survival was 69% in Group 1 and 84% in Group 2. CONCLUSIONS: The operative results--mortality and morbidity, are similar in both groups instead of the highest complexity of the procedures with multiple endarterectomies. The use of this method together with CABG allows complete revascularization in 10% of the operated patients with diffuse atherosclerosis.

Coronary Disease↗
PubMed2001

[Surgical treatment of coronary disease with ischemic mitral regurgitation--early and late results].

UNLABELLED: Patients with ischemic mitral incompetence have a high operative risk and the advantage of repair over replacement in those patients is unclear. In cases of moderate mitral regurgitation and coronary artery disease operative strategy continues to be debated between coronary artery bypass grafting (CABG) alone and concomitant valve replacement or repair. The objective of the study is to review our experience with the different surgical treatments and to assess the impact of pre- and intraoperative factors on mortality, morbidity and long-term survival. METHODS: From July 1990 to May 2000, 102 patients with ischemic mitral regurgitation > 2 + grade underwent operative treatment. CABG alone was performed in 52 and combined procedures in 50 cases (18 replacements and 32 repairs). Mitral repairs were accomplished by Carpentier or Key techniques and/or ring implantation. All replacements were done with preservation of the posterior mitral valve leaflet. RESULTS: Overall mortality is 11(10.8%)-3 patients (5.8%) in the CABG group and 8 (16%) in the combined group (3-16.7% for replacement and 5-15.6% for repair). There was 7 late deaths in both groups. Five year survival was 78% for CABG, 78% for repair and 76 for replacement. CONCLUSIONS: In high risk patients with ejection fraction < 35% and mitral regurgitation < 3 + grade we recommend CABG alone. Valve replacement is the procedure of choice in case of papillary muscle rupture. All patients need complete revascularisation. Good results are obtained with repair techniques and ring implantation.

Adult↗
PubMed2000

Simultaneous pectus and open heart surgery.

Various surgical approaches to pectus excavatum repair concomitant with surgery have been recommended. In this article the authors describe their approach to the problem that they applied in 1989 and onward, successfully, in six consecutive patients. The favorable early and long-term results of these cases illustrate that the simultaneous correction of pectus excavatum and the underlying diseases of the ascending aorta, aortic arch, and the heart can be performed successfully even in emergency situations. The technique recommended provides good cosmetic results and a stable chest wall. It is well applicable in patients of adult age.

Abnormalities, Multiple↗
PubMed1995

[The strategy and procedure in the surgical treatment of thoracic aortic aneurysms].

This is a summed up report on experience had with patients operated for aneurysms of the thoracic aorta since 1994. Between March 1994 and March 1994, a total of 192 patients undergo surgical treatment for aneurysms of the thoracic aorta (mean age 51.2 years). Of them 152 are men (79.1 per cent). Of the total number 109 cases have acute dissecting aneurysms, and 31--chronic aneurysms. In 114 cases the aneurysms is limited to the ascending aorta only, and in 22-in the descending aorta. The transverse aortic arch is involved in 56 patients. The prevailing preoperative clinical symptoms include: chest pain (171 cases), aortic valve incompetence (108), peripheral ischemia (79) and congestive heart failure (63). Hypertension (148 cases) is the commonest underlying cause encountered. Prosthetic replacement of the ascending or descending aorta alone is done in 32 and 22 patients, respectively. Separate graft replacement of ascending aorta and aortic valve are performed in 54 patients. Bentall-De Bono's operation is used in 43 cases. Partial arch replacement is done in 25 patients, and total arch replacement--in sixteen. The early postoperative mortality in patients presenting acute dissecting aneurysms of the aorta is significantly higher (24.77 per cent), as compared to that in patients with chronic aneurysms (6.02 per cent). There is no significant difference in early postoperative lethality, attributable to the location of the process.

Acute Disease↗