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Journal articles on the topic 'Myocardial revascularization'

Author: Grafiati

Published: 4 June 2021

Last updated: 26 July 2024

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1

Vasiliev, D. K., B. A. Rudenko, A. S. Shanoyan, F. B. Shukurov, and D. A. Feshchenko. "Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk." Cardiovascular Therapy and Prevention 19, no. 6 (December 31, 2020): 2697. http://dx.doi.org/10.15829/1728-8800-2020-2697.

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The main reason for incomplete myocardial revascularization is the presence of chronic coronary total occlusion (CTO), which is detected in every fourth patient during coronary angiography. At the same time, a generally accepted approach to the treatment of CTO has not yet been developed.Aim. To assess the rationale of complete myocardial revascularization in patients with multivessel coronary artery disease (CAD) with chronic total occlusion and high surgical risk.Material and methods. This retrospective, open-label, non-randomized clinical trial was carried out included 180 patients multivessel CAD and CTO. The patients underwent endovascular surgery for complete myocardial revascularization. Depending on the success of surgery, the patients were divided into groups of complete and incomplete myocardial revascularization. Endpoints were death, acute coronary syndrome, re-revascularization after 1-year follow-up. Left ventricular (LV) contractility and clinical status of patients in the study groups after 1 year of observation was assessed.Results. The median follow-up was 12,1 months. The successful rate of revascularization was 79,4%. The incidence of main composite endpoint in the group of complete myocardial revascularization was 5,59%, while in the group of incomplete revascularizations — 21,6% (p=0,005).Conclusion. The study showed that low incidence of intraoperative complications and a high successful rate of revascularization are characteristic of complete myocardial revascularization in patients at high surgical risk with multivessel CAD and CTO. Complete myocardial revascularization leads to a significant decrease in the incidence of major coronary events.

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2

Baran, I., B. Ozdemir, S. Gullulu, AA Kaderli, T. Senturk, and A. Aydinlar. "Prognostic Value of Viable Myocardium in Patients with Non-Q-wave and Q-wave Myocardial Infarction." Journal of International Medical Research 33, no. 5 (September 2005): 574–82. http://dx.doi.org/10.1177/147323000503300513.

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This study assessed the amount and prognostic value of myocardial viability in patients with non-Q-wave myocardial infarction (NQMI) and Q-wave myocardial infarction (QMI). A total of 175 patients with MI and an ejection fraction ≤ 45% underwent dobutamine stress echocardiography. On the basis of clinical criteria and myocardial viability, 110 patients were revascularized. The amount of viable myocardium and the clinical outcome were compared in the NQMI and QMI groups. Patients with NQMI exhibited a larger amount of viable myocardium compared with those with QMI. The mortality rate was 6% in patients with NQMI with viable myocardium and subsequent revascularization, 33% in patients with NQMI without viable myocardium or revascularization, 27% in patients with QMI with viable myocardium and subsequent revascularization, and 33% in patients with QMI without viable myocardium or revascularization. In conclusion, our data suggest that patients with NQMI and viable myocardium have the best prognosis after revascularization.

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3

Shevchenko, Yury. "Scintigraphy after Various Methods of Myocardial Revascularization." Cardiology Research and Reports 2, no. 2 (October 13, 2020): 01–06. http://dx.doi.org/10.31579/2692-9759/007.

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Abstract. This article presents a comprehensive assessment of the perfusion-functional state of the LV myocardium after direct and indirect revascularization methods at various times after surgery to evaluate the complex relationship between myocardial viability and the method of revascularization. The research shows a significant advantage to using the YurLeon method of inducing extracardial revascularization of the myocardium in patients with diffuse coronary lesions. Aim. Comparative dynamic of scintigraphic indicators with various methods of revascularization. Materials and Methods.The study included 214 patients who underwent myocardial revascularization in various ways. Gated-SPECT was performed before the operation, as well as 1 month, 6 months, 1 year, and 2 or more years after the operation. Results.The groups of patients after CABG and CABG+YurLeon had differences in SRS indicators one year after surgery: 6.58±7.37 (after CABG) and 1.01±1.49 (CABG+YurLeon)(p<0.05).The most significant changes in systolic thickening (WT) occurred in segments with an accumulation of 26-40%: 1.78±1.84 (CABG), 0.51±0.85 (CABG+YurLeon), 2.6±1.19(PCI); and in segments 41-50%: 1.23±1.10 (CABG), 0.14±0.39 (CABG+YurLeon), 2.1±0.8 (PCI) (p<0.05).In the long-term period after revascularization, the total percentage of LV myocardial segments with "functional-perfusion mismatch" stood at: 11.08±11.69% of segments (CABG), 1.26±2.7% (CABG+YurLeon), 18.44±8.70% (PCI) (p<0.05). Conclusion. Comprehensive diagnostics of patients before surgery, including gated-SPECT, allow medical professionals to more effectively choose the method of revascularization and predict the nearest and separated results. Coronary bypass surgery together with the YurLeon technique of indirect myocardial revascularization in patients with severe diffuse lesions of the coronary artery shows more effective results than other methods of surgically treating IHD.

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4

Mohamed, Salah. "Myocardial Revascularization." Sudan Heart Journal 6, no. 2 (January 1, 2019): 19–20. http://dx.doi.org/10.25239/shj/vol6/no2/commentary.

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5

RAJAN, RS. "MYOCARDIAL REVASCULARIZATION." Medical Journal Armed Forces India 51, no. 3 (July 1995): 194–201. http://dx.doi.org/10.1016/s0377-1237(17)30965-6.

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6

Whittaker, Peter. "Myocardial revascularization." Annals of Thoracic Surgery 61, no. 6 (June 1996): 1874–75. http://dx.doi.org/10.1016/0003-4975(96)80211-6.

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7

Babes, Elena Emilia, Delia Mirela Tit, Alexa Florina Bungau, Cristiana Bustea, Marius Rus, Simona Gabriela Bungau, and Victor Vlad Babes. "Myocardial Viability Testing in the Management of Ischemic Heart Failure." Life 12, no. 11 (November 1, 2022): 1760. http://dx.doi.org/10.3390/life12111760.

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Although major advances have occurred lately in medical therapy, ischemic heart failure remains an important cause of death and disability. Viable myocardium represents a cause of reversible ischemic left ventricular dysfunction. Coronary revascularization may improve left ventricular function and prognosis in patients with viable myocardium. Although patients with impaired left ventricular function and multi-vessel coronary artery disease benefit the most from revascularization, they are at high risk of complications related to revascularization procedure. An important element in selecting the patients for myocardial revascularization is the presence of the viable myocardium. Multiple imaging modalities can assess myocardial viability and predict functional improvement after revascularization, with dobutamine stress echocardiography, nuclear imaging tests and magnetic resonance imaging being the most frequently used. However, the role of myocardial viability testing in the management of patients with ischemic heart failure is still controversial due to the failure of randomized controlled trials of revascularization to reveal clear benefits of viability testing. This review summarizes the current knowledge regarding the concept of viable myocardium, depicts the role and tools for viability testing, discusses the research involving this topic and the controversies related to the utility of myocardial viability testing and provides a patient-centered approach for clinical practice.

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8

Shilov, A. A., N. A. Kochergin, V. I. Ganyukov, A. N. Kokov, K. A. Kozyrin, A. A. Korotkevich, and O. L. Barbarash. "Comparability of scintigraphy data with coronary angiography after surgical myocardial revascularization." Regional blood circulation and microcirculation 18, no. 3 (October 7, 2019): 23–28. http://dx.doi.org/10.24884/1682-6655-2019-18-3-23-28.

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Introduction. Radionuclide imaging is included in diagnostic methods after PCI and CABG in patients with symptoms, but the recommendations caution against routine testing in all asymptomatic patients after revascularization. The paper shows the results of single-photon emission computed tomography after hybrid coronary myocardial revascularization; an analysis of the sensitivity and specificity of three methods of surgical myocardial revascularization was carried out in 12 months.Aim of the study was to determine the sensitivity and specificity of SPECT in determining coronary artery stenosis ≥ 50 % after performing three methods of surgical myocardial revascularization: CABG, PCI, and hybrid myocardial revascularization in patients with coronary artery disease and multi-vascular coronary lesion.Material and methods. A retrospective analysis of 82 patients with stable forms of coronary artery disease who underwent myocardial revascularization for the presence of the multivascular coronary lesion was carried out. The patients were divided into three groups: the first group consisted of 40 patients who underwent CABG, the second – 29 patients after PCI, and the third – 23 patients who underwent hybrid myocardial revascularization.Results. All patients after myocardial revascularization, on average, after 21.8±8.6 months, were hospitalized, where singlephoton emission computed tomography of the myocardium with 99mTc-technetril (SPECT) and control coronarography/ shuntography were performed. The frequency of the presence of significant stenosis during coronary angiography with a perfusion defect of ≥5 % on SPECT during exercise was 50, 50 and 33 % in the CABG, PCI, and hybrid revascularization, respectively (p=0.894). The least sensitivity of SPECT was after hybrid myocardial revascularization (20 %), while in the CABG group, the sensitivity was 71.4 % (p = 0.190). The SPECT specificity indices were much higher: in the GABG, PCI, and hybrid revascularization groups, respectively, 75.8, 79 and 88.9 % (p=0.530).Conclusion. There is no significant relationship between the size of the defect on SPECT and coronary angiography data, regardless of the type of surgical myocardial revascularization in patients after myocardial revascularization. Detection of a perfusion defect with a load of more than 10% in SPECT after surgical myocardial revascularization is the basis for coronary angiography in order to exclude stent restenosis or shunt dysfunction, as well as progression of coronary atherosclerosis.

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9

Bolognese, Leonardo, and Matteo Rocco Reccia. "Myocardial viability on trial." European Heart Journal Supplements 26, Supplement_1 (April 2024): i15—i18. http://dx.doi.org/10.1093/eurheartjsupp/suae005.

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Abstract The concept of myocardial viability is usually referred to areas of the myocardium, which show contractile dysfunction at rest and in which contractility is expected to improve after revascularization. The traditional paradigm states that an improvement in function after revascularization leads to improved health outcomes and that assessment of myocardial viability in patients with ischaemic left ventricular dysfunction (ILVD) is a prerequisite for clinical decisions regarding treatment. A range of retrospective observational studies supported this ‘viability hypothesis’. However, data from prospective trials have diverged from earlier retrospective studies and challenge this hypothesis. Traditional binary viability assessment may oversimplify ILVD’s complexity and the nuances of revascularization benefits. A conceptual shift from the traditional paradigm centred on the assessment of viability as a dichotomous variable to a more comprehensive approach encompassing a thorough understanding of ILVD’s complex pathophysiology and the salutary effect of revascularization in the prevention of myocardial infarction and ventricular arrhythmias is required.

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10

Kovárník, Tomáš, Štěpán Jeřábek, and Petr Kala. "Functional myocardial revascularization." Intervenční a akutní kardiologie 19, no. 1 (June 1, 2020): 39–46. http://dx.doi.org/10.36290/kar.2020.017.

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11

Shneyder, Yu A., V. G. Tsoy, А. А. Pavlov, G. N. Аntipov, I. I. Patlay, T. L. Acobyan, and P. A. Shilenko. "Hibrid myocardial revascularization." RUSSIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 61, no. 1 (2019): 38–44. http://dx.doi.org/10.24022/0236-2791-2019-61-1-38-44.

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12

Mack, Michael J., John J. Squiers, Bruce W. Lytle, J. Michael DiMaio, and Friedrich W. Mohr. "Myocardial Revascularization Surgery." Journal of the American College of Cardiology 78, no. 4 (July 2021): 365–83. http://dx.doi.org/10.1016/j.jacc.2021.04.099.

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13

Ruel, Marc, Volkmar Falk, Michael E. Farkouh, Nick Freemantle, Mario F. Gaudino, David Glineur, Duke E. Cameron, and David P. Taggart. "Myocardial Revascularization Trials." Circulation 138, no. 25 (December 18, 2018): 2943–51. http://dx.doi.org/10.1161/circulationaha.118.035970.

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14

Fonger, James D. "Integrated myocardial revascularization." European Journal of Cardio-Thoracic Surgery 16, Supplement_2 (November 1999): S12—S17. http://dx.doi.org/10.1093/ejcts/16.supplement_2.s12.

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15

Clarke, S. C., and P. M. Schofield. "Myocardial laser revascularization." European Heart Journal 20, no. 17 (September 1, 1999): 1213–14. http://dx.doi.org/10.1053/euhj.1999.1670.

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16

Jones, James W., Sheila E. Schmidt, Bruce W. Richman, Kamal M. F. Itani, Kenneth J. Sapire, and Michael J. Reardon. "SURGICAL MYOCARDIAL REVASCULARIZATION." Surgical Clinics of North America 78, no. 5 (October 1998): 705–27. http://dx.doi.org/10.1016/s0039-6109(05)70346-7.

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17

Mishra, Yugal Kishore, and Jatin Yadav. "Hybrid myocardial revascularization." Indian Journal of Thoracic and Cardiovascular Surgery 34, S3 (March 5, 2018): 310–20. http://dx.doi.org/10.1007/s12055-018-0646-y.

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18

Hao, Steven C., Manish Parikh, and Timothy A. Sanborn. "Percutaneous myocardial revascularization." Current Treatment Options in Cardiovascular Medicine 2, no. 3 (May 2000): 197–201. http://dx.doi.org/10.1007/s11936-000-0013-2.

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19

Zakirov, N. U., A. G. Kevorkov, A. S. Rasulov, and E. Y. Tursunov. "Arrhythmias in Patients after Surgical Myocardial Revascularization." Rational Pharmacotherapy in Cardiology 16, no. 1 (March 2, 2020): 133–38. http://dx.doi.org/10.20996/1819-6446-2020-02-19.

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This work represents literature review data regarding the study of the effect of surgical myocardial revascularization on the processes of electrical myocardial instability underlying the onset of life-threatening ventricular arrhythmias, as well as the possibilities for its non-invasive assessment by studying the heart rhythm variability and turbulence. Analyzed data demonstrated that, relying only on the presence of a viable myocardium, it is often impossible to predict the positive effect of revascularization on the prognosis in patients, especially those with reduced myocardial contractility. Considering the well-studied relationship between myocardial remodeling and neurohormonal activation, such non-invasive methods for assessing vegetative regulation of cardiac activity, as heart rate variability and turbulence may provide additional diagnostic information. The literature data indicate that heart failure, ventricular arrhythmias and recurrences of angina and myocardial infarction are the main problems that determine an unfavorable outcome in the postoperative period. There is important evidence that violations of the vegetative regulation of the heart, the heterogeneity of repolarization processes in the myocardium are integral indicators of the morphofunctional changes occurring in the process of coronary heart disease (CHD) progression. The role of indicators of heart rate variability and turbulence as predictors of sudden cardiac death was proved, mainly due to fatal ventricular heart rhythm disorders and cardiovascular mortality. Along with this, changes in these indicators, and their prognostic role in patients with CHD in revascularization are the subject of discussion, which determines the relevance of further studies on the effect of various methods of revascularization on the electrical instability of the myocardium, as one of the most important factors in the development of life-threatening ventricular arrhythmias that are predictors of sudden cardiac death, especially in patients who previously had acute myocardial infarction. Besides it is important to study the effect of myocardial revascularization on the indicators of cardiac autonomic regulation and the possibility of their use as prognostic criteria before and after surgery.

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20

Frolov, A. V. "Total arterial myocardial revascularization." Complex Issues of Cardiovascular Diseases 7, no. 4S (February 3, 2019): 108–17. http://dx.doi.org/10.17802/2306-1278-2018-7-4s-108-117.

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The review presents the current concept oftotal arterial myocardial revascularization, main studies focusing on it, recent guidelines and commonly used techniques, which let speak about high efficacy this kind procedure. However, in medical society there is a certain part of disbelief with respect to performance of coronary artery bypass grafting using only arterial conduits, and even in justifiable cases when the choice is obvious, the percentage of mentioned operations is still low. It can be explained by both technically much more difficult manipulations and particular risk factors, which contribute discreet approach in the wide use of total arterial myocardial revascularization.

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21

Chloroyiannis, Ioannis A. "Total Arterial Myocardial Revascularization." Angiology 59, no. 2_suppl (May 27, 2008): 80S—82S. http://dx.doi.org/10.1177/0003319708318859.

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22

OESTERLE, STEPHEN, THACH NGUYEN, and KEITH ALLEN. "Percutaneous Myocardial Laser Revascularization." Journal of Interventional Cardiology 11, s5 (October 1998): S134—S136. http://dx.doi.org/10.1111/j.1540-8183.1998.tb00204.x.

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23

Bogaty, Peter, and Gilles R. Dagenais. "Revascularization After Myocardial Infarction." Circulation 99, no. 9 (March 9, 1999): 1272–76. http://dx.doi.org/10.1161/01.cir.99.9.1272.

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24

Frazier, O. H., Denton A. Cooley, Kamuran A. Kadipasaoglu, Seckin Pehlivanoglu, Matthias Lindenmeir, Eddy Barasch, Jeff L. Conger, Susan Wilansky, and W. H. Moore. "Myocardial Revascularization With Laser." Circulation 92, no. 9 (November 1995): 58–65. http://dx.doi.org/10.1161/01.cir.92.9.58.

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25

Oesterle, Stephen N. "Laser percutaneous myocardial revascularization." American Journal of Cardiology 83, no. 4 (February 1999): 46–52. http://dx.doi.org/10.1016/s0002-9149(98)00948-5.

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26

Dudek, Audrey A. "Percutaneous Transluminal Myocardial Revascularization." Critical Care Nursing Clinics of North America 11, no. 3 (September 1999): 327–32. http://dx.doi.org/10.1016/s0899-5885(18)30149-7.

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27

FONGER, J. "Integrated myocardial revascularization*1." European Journal of Cardio-Thoracic Surgery 16 (November 1999): S12—S17. http://dx.doi.org/10.1016/s1010-7940(99)00263-8.

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28

Calafiore, A. "Total Arterial Myocardial Revascularization." Thoracic and Cardiovascular Surgeon 45, no. 03 (June 1997): 105–8. http://dx.doi.org/10.1055/s-2007-1013699.

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29

Wijns, William, Philippe Kolh, Nicolas Danchin, Carlo Di Mario, Volkmar Falk, Thierry Folliguet, Scot Garg, et al. "Guidelines on myocardial revascularization." Revista Portuguesa de Cardiologia (English Edition) 30, no. 12 (December 2011): 951. http://dx.doi.org/10.1016/j.repce.2011.11.010.

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30

Kolh, Philippe, William Wijns, Nicolas Danchin, Carlo Di Mario, Volkmar Falk, Thierry Folliguet, Scot Garg, Kurt Huber, Stefan James, and Juhani Knuuti. "Guidelines on myocardial revascularization." European Journal of Cardio-Thoracic Surgery 38 (September 2010): S1—S52. http://dx.doi.org/10.1016/j.ejcts.2010.08.019.

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31

Abu Rumman, Ali. "Total Arterial Myocardial Revascularization." Basrah Journal of Surgery 9, no. 1 (June 28, 2003): 51–55. http://dx.doi.org/10.33762/bsurg.2003.55247.

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32

PAOLINI, G., M. MARIANI, S. BENUSSI, M. ZUCCARI, G. DICREDICO, C. GALLORINI, and A. GROSSI. "Total arterial myocardial revascularization." European Journal of Cardio-Thoracic Surgery 7, no. 2 (1993): 91–95. http://dx.doi.org/10.1016/1010-7940(93)90187-g.

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33

Kanderian, Anne S., Rahul Renapurkar, and Scott D. Flamm. "Myocardial Viability and Revascularization." Heart Failure Clinics 5, no. 3 (July 2009): 333–48. http://dx.doi.org/10.1016/j.hfc.2009.02.008.

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34

El Oakley, Reida M. "Device-supported myocardial revascularization." Annals of Thoracic Surgery 56, no. 2 (August 1993): 398. http://dx.doi.org/10.1016/0003-4975(93)91202-x.

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Bodnar, Endre, and Donald N. Ross. "Device-supported myocardial revascularization." Annals of Thoracic Surgery 56, no. 5 (November 1993): 1218–19. http://dx.doi.org/10.1016/0003-4975(95)90065-9.

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36

Haq, Muhammad Rehanul, Javed Khurshed Shaikh, Muhammad Hashim Kalwar, Muhammad Hassan Butt, Altaf Hussain Gajoo, and Syed Nadeem Hassan Rizvi. "Health-Related Quality of Life After Complete Versus Infarct Artery-only Percutaneous Coronary Revascularization in Multi-Vessel Disease with St Segment Elevation Myocardial Infarction." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1392–95. http://dx.doi.org/10.53350/pjmhs221651392.

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Objective: The purpose of this study was to compare the HRQoL of patients who had complete revascularization at the time of the first admission to those who underwent revascularization of the infarct artery alone using the EQ-5D (European quality of life-5 dimensions) self-report questionnaire. Background: The effect of revascularization procedures on health-related quality of life (HRQoL) in patients with multivessel disease who undergo primary percutaneous coronary intervention is the subject of controversy (P-PCI). Methods and Results: There was a significant difference between individuals with STEMI who received revascularization of the infarct-related artery alone and those who got total revascularization. we divided the group by the extent of complete revascularization (n=147) or the extent of IRA-only revascularization (n = 153) during the index admission Mobility, self-care, routine activity, pain or discomfort, anxiety, and sadness were all evaluated using the EQ-5D scale. The prevalence of heart failure and the gender of patients were different at baseline. Patients who had full revascularizations had lower mean ±SD (EQ-VAS and EQ-5D) utility ratings than those who had infarct artery revascularizations alone after 2 years of follow-up. (70.00 (±19.9) vs. 51.04 (±17.8), P < 0.04, and 0.71 (±0.03) vs0.61 (±0.03), P<0.005, respectively). Conclusion: Complete revascularization produced clinically significant increases in quality of life when compared to treating just the IRA at 24 months. Keywords: Complete Revascularization, Infarct-related artery, Primary percutaneous coronary angioplasty, ST-segment elevation.

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Opherkin, A. I., S. V. Logvinov, and Y. A. Pokushalov. "Radiofrequency transmyocardial revascularization in experiment." Bulletin of Siberian Medicine 1, no. 3 (September 30, 2002): 39–45. http://dx.doi.org/10.20538/1682-0363-2002-3-39-45.

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Conducted benchmark analysis of influence to mechanical punctures, transmyocardial radiofrequency influence and lazer radiating on myocardium. Study is conducted on 284 rats. Transmyocardial revascularization (ТМR) was executed with use intramuscular needle, Nd:YAG lazer, radiofrequency generator with needle electrode. Study of vascular density and myocardial perfusion was conducted through 1, 2, 4 and 8 weeks. Maximum increasing vascular density was observed on 4 week. In groups with radiofrequency TMR and Nd:YAG TMR specific vascular volume is enlarged in 5 once (26,9 ± 1,9% and 22,2 ± 1,7%, accordingly; Р < 0,05) in contrast with the checking group (4,9 ± 1,6%). In the group with mechanical ТМР specific vascular volume is enlarged small (6,1 ± 1,3%). Increasing an accumulation 99mTc-myoview in the group with radiofrequency TMR occurred on 8 week by comparing with the checking group, it has formed 2,82 ± 0,31% (Р < 0,05) and 1,68 ± 0,21% accordingly. Conclusion: Analysis of vascular density points to alike efficiency of lazer and radiofrequency transmyocardial revascularization. Radiofrequency ТМR causes an increasing vascular density and improvement myocardial perfusion in ischemic myocardium.

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Ostroumov, E. N., E. V. Migunova, E. D. Kotina, E. B. Leonova, I. M. Kuzmina, M. V. Parkhomenko, S. Yu Kambarov, and M. A. Sagirov. "Right ventricular visualization at SPECT perfusion imaging before and after revascularization in patients with postinfarction cardiosclerosis." Transplantologiya. The Russian Journal of Transplantation 15, no. 2 (June 21, 2023): 200–215. http://dx.doi.org/10.23873/2074-0506-2023-15-2-200-215.

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Aim. To evaluate the intersystemic (between the myocardium of the left coronary artery system and the right coronary artery system redistribution mechanisms of perfusion in the myocardium after revascularization in patients with coronary artery disease with focal cardiosclerosis using gated single photon emission computed tomography. Сardiosclerosis foci were initially identified by magnetic resonance imaging. Material and Methods. The study included 17 patients with coronary artery disease with multivessel coronary disease and large-focal cardiosclerosis according to the results of magnetic resonance imaging with contrast; the diagnosis of left ventricular aneurysm was established in 14 patients, the focal subendocardial cardiosclerosis was diagnosed in 3 patients. For various reasons, all patients underwent myocardial revascularization without the left ventricle reconstruction (coronary artery bypass grafting in 10 patients, percutaneous coronary intervention in 7 patients). Magnetic resonance imaging was used as the gold standard for focal cardiosclerosis before revascularization. All patients before and after revascularization underwent gated single photon emission computed tomography with MIBI scan. During the initial analysis of peaks on the profile slices of coronal and transversal midsections passing along the lateral walls of the left and right ventricles, we did not notice a clear visualization of in 8 patients (group 1), while an increased MIBI scan accumulation in the right ventricle myocardium was clearly visualized in 9 patients (group 2). Based on the peaks height of profile curves, we compared changes in the maxima of radiopharmaceutical accumulation before and after revascularization in the lateral walls of the left ventricle and right ventricle. All studies were performed using the original Cardiac Functional Imaging medical program in order to obtain quantitative information about the myocardial function of both the left ventricle, and also the right ventricle. This program made it possible to highlight the right ventricle area even in the case of its weak visualization through the initial formation of parametric images, where the right ventricle area was visualized. Results. When comparing the revascularization results of the two groups, we noted that the left ventricle ejection fraction increased significantly only in patients without initial visualization of the right ventricular myocardium. Left ventricle ejection fraction did not change after revascularization in patients with initially increased accumulation of the radiopharmaceutical in the right ventricle. Globally, only an improvement in the diastolic function of the left and right ventricles was noted in the latter group of patients. In addition, an increase in the right ventricular uptake level was noted for patients with focal cardiosclerosis and the initially increased uptake in the right ventricle after the maximum possible complete myocardial revascularization, which may indicate a redistribution of perfusion in favor of a more intact right ventricular myocardium. Conclusions. 1. In patients without signs of increased visualization of the right ventricle (group 1) after revascularization, we revealed a statistically significant increase in the left ventricle ejection fraction (p-value=0.024), a decrease in the end-systolic volume (p-value=0.024), an increase in the motion in segments corresponding to the peri-infarct scar zone (p-value=0.016), and a change in systolic thickening in the segment of the basal parts of the anterolateral wall (p-value=0.046). 2. Initially increased visualization of the right ventricle in patients with extensive focal cardiosclerosis in the myocardium of the left ventricle suggests the absence of the left ventricle ejection fraction increase after myocardial revascularization. 3. An increase in the visualization of the right ventricle after complete myocardial revascularization indicates an intersystemic redistribution of perfusion in favor of the preserved myocardium of this part of the heart.

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Dedov, Ivan Ivanovich, and Sergey Anatol'evich Terekhin. "Myocardial revascularization in diabetic patients." Diabetes mellitus 13, no. 4 (December 15, 2010): 18–23. http://dx.doi.org/10.14341/2072-0351-6052.

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Patients with diabetes mellitus (DM) are predisposed to diffuse and rapidly progressing forms of atherosclerosis which significantly increasesthe probabilityof surgical revascularization of myocardium. However, unique pathophysiological features of atherosclerosis in DM patients are responsiblefortheirunusual reaction to an arterial injury associated with percutaneous coronary intervention (PCI).Numerousstudies showed that DM is an independentrisk factor of restenosis following successful balloon angioplasty or stenting of coronary arteries and significantly increases the need forsecondary myocardial revascularization that compromises the outcome of the treatment.Preliminary data indicate that the use of drug-releasing stentsdecreases the need for repeat interventions in both diabetic and non-diabetic patients without negative effect on certain clinical end-points, such asmyocardial infarction and mortality. Any surgical intervention causes less pronouncedimprovement of the clinical picture or prognosis in patients withfunctional class I or II angina of effort compared with optimal medicamental therapy. Surgical revascularization, PCI and aortocoronary bypasssurgery (ACB) is indicated to patients that remain symptomatic despite adequate conservative therapy. The choice of an optimal revascularizationstrategy is of primary importance for DM patients with multiple lesions in the coronary system. Randomized studies comparing multivascularPCI withballoon angioplasty and holometallic stents demonstrated the advantage of ACB for DM patients who showed a higher survival rate, lower frequencyof infarctions and secondary revascularization. Certain authors demonstrated that ACB surpasses PCI even when drug-releasing stents are used.It may be hoped that the ongoing randomized studies comparing the two modalities will help to develop the optimal strategy for myocardial revascularizationindiabetic patients.

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Dato, Guglielmo Actis, and Marco Picichè. "Off-pump Techniques of Surgical Myocardial Revascularization." Reviews on Recent Clinical Trials 14, no. 2 (May 31, 2019): 116–19. http://dx.doi.org/10.2174/1574887114666190201112053.

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Background:Before the advent of CABG, standardized in the late '60s by Favaloro and Effler, patients with myocardial ischemia underwent indirect and heterogeneous off-pump methods of myocardial revascularization.Methods & Results:Indirect revascularization, such as periaortic nerve plexus interruption, Vineberg operation, Sen procedure and, less remotely, TMR Laser and stem cell transplantation, represented some of the ways to achieve myocardial revascularization. Nowadays, direct coronary revascularization is the only established technique and may be performed either on-pump or off-pump.Conclusion:The comparison of off-pump and on-pump myocardial revascularization paved the way to an endless debate between the advantages and disadvantages of each technique. In this article, we review the old and current off-pump approaches of surgical myocardial revascularization.

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Brown, TA. "Hibernating myocardium." American Journal of Critical Care 10, no. 2 (March 1, 2001): 84–91. http://dx.doi.org/10.4037/ajcc2001.10.2.84.

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According to estimates, up to 50% of patients with coronary artery disease and impaired left ventricular function have areas of viable myocardium. This dysfunctional, yet viable myocardial tissue, which can improve functionally after myocardial oxygen supply is reestablished, has been called hibernating myocardium. The possible pathophysiological mechanism that leads to hibernating myocardium is controversial: is the phenomenon due to persistent ischemia or is it the result of repetitive episodes of ischemia and reperfusion, such as myocardial stunning? Regardless of the mechanism, the presence of viable myocardial tissue indicates that structural and biochemical cellular changes occur, and the recovery of left ventricular function after revascularization depends on the severity and extent of these changes. Whether these changes reflect a long-lasting state of cellular dedifferentiation, an adaptive process that is reversible, or eventually lead to cellular degeneration has not been determined. Perhaps early detection of hibernating myocardial tissue via noninvasive imaging techniques used to assess contractile response, integrity of the cellular membrane, myocardial metabolism, and myocardial blood flow and subsequent early coronary revascularization may prevent infarction and deterioration in left ventricular function. Knowledge that reversible changes and areas of viable myocardium can occur in patients with left ventricular dysfunction will assist healthcare providers in the care and management of patients with hibernating myocardium.

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Khairutdinov, E. R., Z. Kh Shugushev, D. A. Maksimkin, A. G. Faibushevich, G. I. Veretnik, A. V. Arablinskii, and Yu V. Tarichko. "ENDOVASCULAR TREATMENT OF ISCHEMIC HEART DISEASE IN PATIENTS WITH MULTIVESSEL CORONARY ARTERY DISEASE: IMMEDIATE AND LONG-TERM RESULTS." Annals of the Russian academy of medical sciences 67, no. 7 (July 10, 2012): 8–14. http://dx.doi.org/10.15690/vramn.v67i7.334.

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Immediate and long-term results of endovascular treatment of multivessel coronary artery disease by using different revascularization strategies were analyzed in 171 patients. Duration of follow up ranged from 12 to 18 months. Complete myocardium revascularization was performed in 63 patients, culprit vessel revascularization ― in 86 pts and incomplete revascularization ― in 22 pts. Results of this study showed that strategy of complete and culprit vessel revascularization in patients with multivessel coronary artery disease has comparable immediate and long-term results. Strategy of incomplete revascularization reduce immediate clinical success and lead to increased number of myocardial infarctions and needs of coronary artery bypass surgery in long-term follow-up period.

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Danilovich, A. I., and R. S. Tarasov. "Long-term outcomes of myocardial and cerebral revascularization with combined or staged percutaneous interventions and carotid endarterectomy." Complex Issues of Cardiovascular Diseases 9, no. 1 (March 25, 2020): 42–51. http://dx.doi.org/10.17802/2306-1278-2020-9-1-42-51.

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Aim To evaluate in-hospital and long-term outcomes of myocardial and cerebral revascularization with combined or staged PCI and carotid endarterectomy.Methods.263 myocardial and cerebral revascularizations with PCI and CEA in patients with combined cerebral and coronary artery lesions in the period from 2011 to 2017 were performed. Patients were divided into two groups depending on the surgical strategy. Patient (n = 133) who underwent a staged intervention (CEA and PCI) were included in Group 1, whereas patients (n = 130) who underwent a hybrid intervention (CEE+PCI CA) were included in Group 2. The mean follow-up was 3.5 years.Results.100% of patients in Group 2 underwent coronary and internal carotid revascularization according to the results of in-hospital and long-term follow-up. 81.35% of patient in Group 1 underwent PCI and CEA, whereas 3.01% of patients underwent only PCI and 6.77% of patients – CEA. 1.5% of patients in Group 1 did not receive any surgical treatment. The most common causes of incomplete revascularization were the subsequent change of the initially defined treatment for myocardial (6.02%) or cerebral revascularization (0.75%). The rest refused the second stage, or it was associated with extremely high risk and the strategy was switched to the conservative therapy.Conclusion.100% of patients received hybrid myocardial and cerebral revascularization during one hospitalization. It allowed reducing mortality from MI and stroke during the waiting period for the next stage of the treatment in Group 1 (almost 5%). Hybrid interventions can be used in patients with high risk for open-heart surgery, severe comorbidities (obesity, diabetes, renal dysfunction), significant coronary and cerebral artery lesions with high risk of MI and stroke. However, hybrid approach was associated with high rate (almost 7%) of non-fatal MI in the long-term follow-up.

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Rustamova, Ya K. "Actual Problems of Diagnostics of Viable Myocardium." Kardiologiia 59, no. 2 (March 8, 2019): 68–78. http://dx.doi.org/10.18087/cardio.2019.2.10243.

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The article presents modern analysis of the studies and reflects the key problems concerning the feasibility of performing cardiac MRI for assessment of myocardial viability in patients with history of myocardial infarction (with postinfarction cardiosclerosis), as well as the effectiveness of the method for predicting restoration of the function of hibernating myocardium after myocardial revascularization.

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Shabana, Adel, and Ayman El-Menyar. "Myocardial Viability: What We Knew and What Is New." Cardiology Research and Practice 2012 (2012): 1–13. http://dx.doi.org/10.1155/2012/607486.

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Some patients with chronic ischemic left ventricular dysfunction have shown significant improvements of contractility with favorable long-term prognosis after revascularization. Several imaging techniques are available for the assessment of viable myocardium, based on the detection of preserved perfusion, preserved glucose metabolism, intact cell membrane and mitochondria, and presence of contractile reserve. Nuclear cardiology techniques, dobutamine echocardiography and positron emission tomography are used to assess myocardial viability. In recent years, new advances have improved methods of detecting myocardial viability. This paper summarizes the pathophysiology, methods, and impact of detection of myocardial viability, concentrating on recent advances in such methods. We reviewed the literature using search engines MIDLINE, SCOUPS, and EMBASE from 1988 to February 2012. We used key words: myocardial viability, hibernation, stunning, and ischemic cardiomyopathy. Recent studies showed that the presence of viable myocardium was associated with a greater likelihood of survival in patients with coronary artery disease and LV dysfunction, but the assessment of myocardial viability did not identify patients with survival benefit from revascularization, as compared with medical therapy alone. This topic is still debatable and needs more evidence.

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Popma, Jeffrey J., Senthil Nathan, Robert C. Hagberg, and Kamal R. Khabbaz. "Hybrid myocardial revascularization: An integrated approach to coronary revascularization." Catheterization and Cardiovascular Interventions 75, S1 (March 1, 2010): S28—S34. http://dx.doi.org/10.1002/ccd.22402.

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Surev, Artiom, Lucia Ciobanu, Mihaela Ivanov, Ion Popovici, Valery Kobets, and Mihail Popovici. "Myocardial remodeling in NSTEMI patients with intermediate and low cardiovascular risk exposed to delayed revascularization." Moldovan Medical Journal 64, no. 2 (May 2021): 26–32. http://dx.doi.org/10.52418/moldovan-med-j.64-2.21.05.

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Background: Nowadays, the impact of the delayed myocardial revascularization (DMR) (>72h) in patients with myocardium infarction without STsegment elevation (NSTEMI) having either intermediate or low cardiovascular risk (ILCR) on quality of post-infarction myocardial remodeling is not well established. Aim of the study: The comparative evaluation of cardiac functional recovery of NSTEMI patients undergoing either revascularization <72h or DMR (72h–30 days) in a follow-up of 6 months. Material and methods: The study was realized in 2 homogenic series of NSTEMI patients with ILCR exposed to revascularization: <72h (control) or to DMR (72h–30 days). The echocardiographic and physical test indices were registered at the 2nd day since revascularization and after 6 months. Results: The increasing ratio of ejection fraction was significantly higher in patients with DMR compared to control (5.24% vs 1.73%). Likewise, the contractility ability of left ventricle improved better, proven by systolic volume diminution, lower value of akinetic areas, and less patients with class III of heart failure according to New York Heart Association (4 vs 29%). More than that, DMR was associated with higher physical endurance. Conclusions: NSTEMI patients with ILCR exposed to delayed myocardial revascularization (72h–30 days) had a better post-infarction recovery after 6 months according to dynamics of echocardiographic and physical tolerance indices in comparison with patients revascularized <72h.

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Visker, Ya Yu, D. N. Kovalchuk, A. N. Molchanov, and O. R. Ibragimov. "Coronary endarterectomy in myocardial revascularization." Russian Journal of Cardiology 26, no. 8 (September 4, 2021): 4310. http://dx.doi.org/10.15829/1560-4071-2021-4310.

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Aim. To compare the immediate outcomes of combined coronary artery bypass grafting (CABG) with coronary endarterectomy (CE) and isolated CABG.Material and methods. This retrospective study included 192 patients with stable angina who underwent myocardial revascularization in the period from January 2016 to August 2018. The patients were divided into 2 groups. Group 1 included patients who underwent combined CABG and CE, while group 2 — patients who underwent isolated CABG. Patients in both groups did not differ in the main preoperative characteristics, with the exception of the incidence of obesity and right coronary artery disease.Results. In-hospital mortality in group 1 was 2,2% (n=2), in group 2 — 2% (n=2). The incidence of perioperative myocardial infarction in group 1 was 1% (n=1) and in group 2 — 0%. There were no significant differences between groups in the following postoperative parameters: in-hospital mortality, perioperative myocardial infarction, need and duration of inotropic support, duration of mechanical ventilation (MV) and need for long-term mechanical ventilation, stroke, arrhythmias, resternotomy for bleeding. In group 1, encephalopathy (11,8%) and respiratory failure (12,9%) were significantly more common.Conclusion. Combined CABG and CE is a safe technique for achieving complete myocardial revascularization in diffuse coronary artery disease, since, in comparison with isolated CABG, there is no increase in the incidence of death and perioperative myocardial infarction. However, in this category of patients, an increase in the incidence of non-lethal, non-disabling cerebral and pulmonary complications should be expected.

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Teplova, N. V. "CLOPIDOGREL FOR SELECTIVE MYOCARDIAL REVASCULARIZATION." Russian Journal of Cardiology, no. 3 (March 30, 2016): 97–100. http://dx.doi.org/10.15829/1560-4071-2016-3-97-100.

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Stefanini, Giulio G., Giovanni Malanchini, and Jorge Sanz-Sanchez. "Myocardial revascularization appropriateness in Italy." Journal of Cardiovascular Medicine 20, no. 11 (November 2019): 768–70. http://dx.doi.org/10.2459/jcm.0000000000000867.

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