[Surgical tactics and results of aortocoronary shunting in patients with chronic forms of ischemic heart disease and reduced left-ventricular ejection fraction].

Two groups of patients whose ejection fraction was below 0.45, underwent aortocoronary shunting of one to five arteries: patients without myocardial scarry changes (group 1) and those with expansive intra- and transmural myocardial scarry changes (group 2). The latter group was more difficult in terms of coronary bed affection, myocardial contractility and a greater proportion of patients with circulatory insufficiency, which dictated the type of anesthesia, myocardial protection and the surgical techniques in these patients.