Analysis of the use of coronary balloon angioplasty in staged treatment of patients with valvular heart disease and stenosing coronary arterial lesion (twelve-year experience)
Shumakov, V.I.; Semenovskiĭ, M.L.; Sokolov, V.V.; Gureev, A.V.; Mironkov, B.L.
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk 12: 3-7
2006
ISSN/ISBN: 0869-6047 PMID: 17806199 Document Number: 600150
The authors present the analysis of their twelve-year experience in staged treatment of patients with combined pathology using coronary balloon angioplasty (CBA). CBA was performed in 83 patients (mean age 61.7 +/- 9.0 years) prior to heart valve replacement. Mean functional class according to New York Heart Association (NYHA) was 3.3 +/- 0.5. Thirty-one (37.3%) patients displayed signs of circulatory decompensation. Nine (10.8%) patients had had myocardial infarction. Thirteen (15.6%) patients had been operated on for valvular heart disease. The authors present their own method of staged treatment of combined pathology, describe and substantiate a regimen of therapy with desaggregants, the timing of the second stage of treatment, and post-operative therapy with desaggregants. In-hospital lethality was 8.4%, which was lower than the lethality of combined surgery (14.5%). Actual three-year survival rate was totally comparable to that of patients who had undergone a combined surgery (87.8% and 88%, respectively). The method of two-staged treatment of patients with combined (valvular plus coronary) pathology allows for a significant improvement in their surgical treatment, and deserves further study and clinical application.