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Information × Registration Number 0224U000691, 0120U103769 , R & D reports Title To develop and improve the system of complications prevention and to increase efficacy of surgeon treatment in high-risl patients with coronary heart disease popup.stage_title Head Rudenko Anatolii V., Доктор медичних наук Registration Date 10-01-2024 Organization National institute of CVS of Amosov name. Academy of medical science Ukraine popup.description2 Preoperative risk stratification according to the EuroSCORE (ES) II scale is optimal in cardiac surgery for coronary artery disease (CAD). ES II > 5% predicts a high risk of postoperative complications and death. According to the results of the study, it was found that performing coronary artery bypass gragting (CABG) on a working heart by experienced cardiac surgeons allows to reduce the level of postoperative complications and mortality of high-risk patients. Performing off-pump operations allows to minimize complications in high-risk patients. In complicated forms of CAD, in order to reduce the ischemic time, it is recommended to perform off-pump CABG with further resection of a left ventricular aneurysm or valvular correction on-pump. A protocol of surgical tactics for posterior-basal aneurysms of the left ventricle has been developed. A direct correlation was found between the length of stay of patients in the intensive care unit and the predicted risk according to the ES II scale. A direct correlation was found between the terms of discharge after surgery and the severity of the patients' condition according to the ES II (r=0.4583; p < 0.0001) and STS (r=0.4446; p < 0.0001) scales. Personalized drug therapy in the perioperative period has been improved, taking into account the volume of the operation, comorbidity, drug interactions, under the control of hemodynamics, laboratory parameters and creatinine clearance. Algorithms for searching of comorbidity on the eve of cardiac surgery, gastroprotection, antiplatelet and anticoagulant therapy, and statin therapy in the perioperative period have been developed and implemented. Implementation of protocols for perioperative management of high-risk patients with CAD and comorbidity improved the results of cardiac surgery and allowed to reduce the level of postoperative complications from 16.7 to 4% (p=0.0190).  Product Description popup.authors Andrushchenko Tetyana A. Olena K. Gogayeva Kashenko Yurii Mazur Andrii P. Poznyak Viktoriya I Sergii A. Rudenko Sas Serhii popup.nrat_date 2024-01-10 Close