Martsinkiavichius A, Iablonskene D, Paliushchinskaia N, Kosinskas E, Uzhdavinis G, Ivashkiavichene L, Vil'dzhiunene S, Aĭdetis A, Norkunas G, Lautsiavichius A
Grud Serdechnososudistaia Khir. 1990(3):17-20.
The authors analyse 82 patients with aggravation of their clinical condition in the late-term periods after aortocoronary shunting. All were subjected to coronaroshuntography 3.6 +/- +/- 0.5 years on the average, after the operation. The main noninvasive criteria of impaired functioning of the shunts were: increase of the degree of angina pectoris (functional class III-IV according to the Canadian classification), diminished tolerance to physical exertion, appearance of "active" myocardial ischemia. Disturbed functioning of the shunts was mainly manifested within the first year, while progression of atherosclerotic changes in the unshunted arteries--in later periods. The main causes of incompetence of the shunts were: small diameter of the shunted arteries, low rate of blood flow in the shunts, and feverish condition of patients lasting for a long time after the operation.
作者分析了82例在主动脉冠状动脉分流术后晚期临床病情加重的患者。平均而言，所有患者在术后3.6±0.5年接受了冠状动脉分流造影。分流功能受损的主要非侵入性标准为：心绞痛程度加重（根据加拿大分类为III-IV功能级）、体力活动耐量降低、出现“活动性”心肌缺血。分流功能障碍主要在第一年内表现出来，而未分流动脉的动脉粥样硬化变化进展则在后期出现。分流功能不全的主要原因是：分流动脉直径小、分流中血流速度低以及患者术后长时间持续发热状态。
