Aksonova I. Surgical Treatment of Ischemic Heart Disease with Concomitant Atherosclerosis of the Ascending Aorta

This dissertation is dedicated to the problem of surgical treatment of patients with coronary heart disease combined with atherosclerosis of the ascending aorta. This work is the first national study that summarizes known and outlined new ways of solving a scientific problem - increasing the efficiency of surgical treatment of patients with coronary artery disease and atherosclerosis of the ascending aorta and to improve survival rates and reduce the number of complications in the hospital stage by optimizing the methods of diagnosis and surgical treatment. Evaluation studied in the results of operations of surgical revascularization in these patients allowed to determine the indications and contraindications of different methods for surgical treatment of this pathology. The studies allowed identifying risk factors for mortality and complications in the hospital stage, atheromatous embolism associated with peripheral vascular disease, including brain and mechanically damage the wall of the ascending aorta. It is shown that the combination of echocardiography and epiaortic ultrasound based on its choice of optimal tactics of myocardial revascularization has good immediate results. Developed of algorithm and put it in to practice selection is optimal methods of surgical treatment of patients with CHD and atherosclerosis of the ascending aorta allowing for the ascending aorta atherosclerotic lesions in each patient. Development and implementation of advanced algorithms surgical revascularization has reduced the number of complications from 12 % to 5.1 % and mortality rates - from 3.3 % to 0.5 %.