Gutovskyi V. Surgical treatment of coronary artery disease with concomitant type 2 diabetes mellitus

Dissertation is devoted to the problems of diagnostic and surgical treatment of coronary artery disease (CAD) with type 2 diabetes mellitus (DM), increase of effectivity and safety of coronary artery bypass grafting (CABG) by optimizing surgical tactics, technique and preoperative treatment of patients. Shown the results of CABG in 633 patients with CAD with DM type 2 which were performed in the "National Amosov's Institute of Cardiovascular Surgery NAMS of Ukraine" from 2005 till 2010 yy. It was determined that patients with concomitant type 2 DM have heavier preoperative status and significantly severe lesions of coronary arteries than patients without DM, that complicates CABG. Performing off-pump CABG for patients with concomitant type 2 DM, with improved techniques and developed methods of complete revascularization in addition with strict normoglycemia in the perioperative period made it possible to reduce the rate of complications in the postoperative period (acute heart failure - from 8,3 % to 6,0 %, acute cerebrovascular events - from 2,8 % to 0,7 %, and infectious complications - from 5,6 % to 4,0 %) and decrease hospital mortality from 2,8 % to 0 %. We identified the factors that affect the long term outcome and proposed methods of prevention of complications.