Galych S. Optimization of the technique of performing coronary anastomoses taking into account the anatomical features of the anastomosing vessels.

The dissertation is devoted to determining the most favorable methods of performing coronary anastomoses to increase the volume blood flow through it. The paper presents an analysis of the results of a study of 516 coronary anastomoses, created by different techniques and with different anatomical preconditions of the anastomosed vessels. To study the anatomical and functional characteristics of the created anastomoses, a hydrodynamic method with its own design and modern methods of vascular examination were used: ultrasonic method (flowmetry, TTFM), intravascular ultrasound (IVUS), angiography and morphological method. The results of the studies allowed us to determine the factors that significantly affect the volume blood flow through coronary anastomosis and to determine the most favorable of them to achieve the maximum capacity of the anastomosis. The optimum parameters and methods of performing coronary anastomoses allow to obtain configurations of coronary anastomoses with maximum values of volumetric blood flow. The maximum volume blood flow due to such anastomosis ensures the maximum duration of coronary artery bypass surgery and the percentage of its patency in the early and late periods after surgery. Anastomoses designed in this way provide maximum circulation in the ischemic area of the myocardium, which improves the results of coronary artery bypass, which is reflected in the pumping function of the heart and improve the condition and prolong the life of patients, respectively.