[Comparison of clinical and postmortem evaluation of coronary artery stenosis: data on patients who died after coronary artery bypass surgery].

Comparison of quantitative clinical angiographic data with postmortem coronary angiographic and visual evaluation of transversal sections of coronary arteries (CA) data was made. CA of 25 patients who died after coronary artery bypass surgery were investigated. Comparison of clinical and postmortem angiographic data showed more frequent underestimation (12%) and overestimation (12%) of stenosis in clinical angiography in cases of right CA injury.

[Transesophageal electrostimulation of the atria in assessing the degree of the coronary bed lesion in ischemic heart disease patients].

Electrocardiographic changes in response to esophageal atrial electrostimulation were examined in relation to the severity of coronary-bed affection in 99 patients with suspected coronary heart disease. Esophageal atrial electrostimulation was equal, in terms of specificity and sensitivity (73 and 78%, respectively), to bicycle ergometry (77 and 74%), and was superior to it by far in terms of adjustment to diagnostic electrocardiographic criteria. A direct relationship was demonstrated between total ST depression induced by esophageal atrial electrostimulation and the extent of coronary-bed affection expressed as the number of affected coronary arteries or the impaired blood supply area.

[Technical potentials for performing intravital aortocoronary shunting in sudden death from ischemic heart disease (based on postmortem coronary angiographic data)].

Technical feasibility of aortocoronary shunting was examined retrospectively in 70 cases where sudden coronary death had occurred outside of hospital. Postmortem coronary angiograms, coronary arterial cross sections made at 5 mm intervals, and the nature and spread of focal myocardial lesions were studied. A coronary artery with more than 50% of its lumen affected in the proximal or middle part, but no significant narrowings in the distal channel, was considered shuntable if myocardial focal lesions did not exceed 15% of left-ventricular and interventricular-septum volume.

[Elaboration of criteria for selection of patients with chronic ischemic heart disease for direct myocardial revascularization surgery].

Indications for direct myocardial revascularization were specified on the basis of a new parameter: the disrupted myocardial blood supply zone (DBSZ). Absolute indications for the procedure included: a more than 50% narrowing in the diameter of the main trunk of the left coronary artery; two or 3 vessels affected with the DBSZ accounting for at least 75% of the left-ventricular and interventricular-septum weight. Relative indications included: two or three affected vessels with the DBSZ covering between 50 and 75% of the left-ventricular and interventricular-septum weight; and a more than 50% isolated proximal narrowing of the diameter of the anterior interventricular branch with any type of coronary blood supply, of the right coronary artery, with types 10:10 and 11:9, and of the circumflex branch, with types 5:15 and 6:14.