Gogayeva O. Tunneled coronary arteries: clinical and diagnostic aspects and treatment.

Dissertation to obtain a philosophic degree in medical sciences (PhD med) іn speciality 14.01.04 - cardiovascular surgery. - Government facility "National M. M. Amosov Institute of Cardiovascular Surgery of the AMS of Ukraine", Kyiv, 2009. Dissertation is dedicated to study the diagnostic problems for patients with symptomatic tunneled coronary arteries (TCA), as well as to develop the fundamental analysis and conduction of the most effective methods of verification and treatment for the patients with given anomaly. Dissertation study material consisted of 317 patients, where ТCА was diagnosed during angiography in 113, and 204 patients with intramural course of coronary arteries (CA) were revealed during coronary arteries bypass grafting (CABG) operation. The analysis of symptoms is carried out depending on a degree of systolic compression. The new ECG and angiographic signs of myocardial bridges (MB) were developed for the first time. The correlation analysis of the given methods of research with intraoperative findings was carried out. The features of operation and early postoperative period for patients with intramural course of CA are revealed. The possible reasons of the myocardial ischemia occurrence at the given anomaly were investigated. The algorithms of diagnostics and treatment of the patients with symptomatic ТCА are scientifically proved.