GABRIYeLYaN A. Peculiarities of tactics for surgical treatment of ischemic heart disease patients with an unstable angina.

The dissertation is dedicated to the problems of diagnostics, peculiarities of tactics and surgical treatment of the various forms of an unstable angina.On the basis of 142 patients study with an unstable angina 4 groups of patients with a various level of risk of a surgical intervention were selected: 1 - patients with an early postmyocardial infarction angina; 2 - patients with destabilizing of a status during the first year after MI; 3 - patients with destabilizing of a status after one year, after MI; 4 - patients without MI in an anamnesis. It's shown, that the degree of gravity of the disease is increased from the 4-th group to the first. The medicamental therapy allows to stabilize a status on the average in 74,7 % of cases. The application of a coronary angioplasty in the complex of stabilizing measures has allowed to increase an amount of stabilized patients by 20 % in the whole group. On the basis of the conducted research the peculiarities of an operation performance were elaborated, the ris k factors of a coronary bypass grafting are detected; the peculiarities of tactics for surgical treatment were elaborated depending on the form of unstable angina. Standardized application of the elaborated algorithm of a complex treatment of patients with unstable angina in examination group has allowed to reduce frequency of postoperative complications from 84,5 % to 48,5 %, hospital mortality from 6,3 % up to 4,2 %. The immediate and remote outcomes of surgical treatment of patients with unstable angina are studied depending from the type of the disease course.