Outcomes of surgical management of elderly and aged patients with complicated forms of coronary artery disease

Mikheev A.A., Tkachev E.V., Kranin D.L., Krashonkin A.A., Vinogradov D.V., Zamskii K.S.
42^nd Cardiosurgical Department Federal State Facility «Chief Military Clinical Hospital named after N.N. Burdenko», Moscow, Russia

The article is dedicated to comparative analysis of surgical management of elderly and aged patients presenting with complicated forms of coronary artery disease (CAD). Suggested herein is an algorithm of concerning the choice of methods aimed at surgical correction of postinfarction aneurysms of the right ventricle of the heart and postinfarction ruptures of the interventricular septum in these patients, depending on the morphological structure of the right-ventricular postinfarction aneurysms and postinfarction ruptures of the interventricular septum, followed by determining the incidence rate of using «complete» and «incomplete» myocardial revascularization in elderly and aged patients with complicated forms of CAD depending on peculiarities of the coronary blood flow. Also considered herein is efficacy of preventing rethrombosis following correction of right-ventricular postinfarction aneurysms and thrombectomy. The article is based on studying a total of forty-two 60-to-78-year-old patients with CAD.

The measures taken made it possible to decrease postoperative lethality and postoperative complications rate in the patients concerned.

KEY WORDS: coronary artery atherosclerosis, coronary artery bypass grafting, postinfarction cardial aneurysm, prevention of rethrombosis, postinfarction rupture of the interventricular septum, elderly and aged patients.

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