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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina


J.D. Vasiljević1, R. Vidaković2, P. Otašević2, Z.V. Popović1, S. Gradinac2, Z.B. Popović2, M. Mirić2 and A.N. Nešković2 .
Institute of Pathology, Belgrade University School of Medicine1, Belgrade,
Dedinje Cardiovascular Institute2, Belgrade, Yugoslavia

Background and method: There were 1309 patients, 1109 (85%) male and 200 (15%) female with the mean age of 55,8 years (29-72 years). The majority of the patients (72%) had unstable pectoral angina. Previous myocardial infarction was registered in more than 40% patients. Preoperative ejection fraction (EF) higher than 30% was registered in 1213 patients (92%). EF between 20 and 30% had 88 patients (6,7%) and EF lower than 20%, 8 patients (1,3%) In 1268 cases (96%) we performed myocardial revascularisation or left anterior descending artery (LAD) using left IMA. The first diagonal artery, the second diagonal artery, as well as a marginal artery were revascularisated in 18, 3 and 2 cases, respecitively. In 35 patients, revascularisation of LAD was performed after endarterectomy. Beating heart surgery was performed in 20 cases, in 18 cases approach was through the left -sided minithoracotomy and in the remaining two cases through the longitudinal medial sternotomy. In 4 patients, double myocardial revascularisation on LAD and right coronary artery (RCA) was done, in the one of them on the beating heart. During the last year, myocardial revascularisation using IMA was don ein 76% of the cases. Results: Postoperative mortality (30 days) was 2,4% (32/1309). Cardial causes of death were observed in 15 (46%) patients and non-cardial in 17(54%). Conclusions: In our opinion, myocardial revascularisation using IMA shows best results in younger patients with closed proximal stenosis on LAD, especially in the case after failing PTCA. We estimate that left myocardial hypertrophy, bad left ventricle (EF<30%), diffuse and distal coronary disease myocardial revascularisation associated with valvular procedures, are not limiting factors for myocardial revascularisation using sceletonised IMA.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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