ANALYSIS OF THE COMPLETENESS OF THE PERFORMED REVASCULARIZATION DURING CORONARY BYPASS TREATMENT IN PATIENTS WITH ISCHEMIC HEART DISEASE TAKING INTO ACCOUNT GENDER
DOI:
https://doi.org/10.11603/2414-4533.2025.2.15397Keywords:
coronary arteries, distal anastomoses, age characteristics, gender aspects, coronary artery bypass graftingAbstract
The aim of the work: to analyze the anatomical features of stenosing atherosclerosis and the completeness of revascularization in patients with coronary heart disease, taking into account gender and age.
Materials and Мethods. The study included patients with ischemic heart disease who underwent coronary artery bypass grafting on a working heart. The total number of study participants was 3672, of which 613 were women and 3059 were men, with an average age of (61.1±0.8) years. The material for the study was data from 3672 protocols of coronary artery bypass grafting operations for the period from 2015 to 2021. All study participants are under dispensary observation of the State Institution «Amosov National Institute of Cardio-Vascular Surgery of the National Academy of Medical Sciences of Ukraine» and at the municipal non-profit enterprise «Cherkasy Regional Cardiology Center of the Cherkasy Regional Council». To standardize approaches, the success of revascularization was assessed in three main branches of the coronary arteries: the circumflex branch of the left coronary artery, the right coronary artery, and the anterior interventricular branch of the left coronary artery.
Results. During the analysis of the frequency of diffuse lesions of the coronary arteries, it was found that in the group of young patients the corresponding frequency was the lowest in the entire sample regardless of gender. It was established that the frequency of diffuse lesions of the coronary arteries progressively increased with age with a tendency to reliability. During the statistical analysis of the comparison of the frequency of diffuse lesions of the coronary arteries taking into account gender, it was found that diffuse lesions significantly prevailed in women, (χ²=161.96; p=0.0001). When analyzing the frequency of revascularization of the main branches of the coronary arteries, which are used to judge the results of its completeness, namely, the frequencies of blood flow restoration in the anterior interventricular branch, circumflex branch and right coronary artery, it was found that the most frequently affected by stenosing atherosclerosis were: anterior interventricular branch – 92.4 %, right coronary artery – 73.0 % and circumflex branch – 71.2 %. Moreover, in female patients, the lesion of the main branches of the coronary arteries by stenosing atherosclerosis did not differ from the corresponding lesions in men. It was found that in women, the most frequently affected were the anterior interventricular branch – 92.8 %, right coronary artery – 72.9 % and circumflex branch – 73.6 %. While in male patients, the frequency of lesions of the coronary arteries by stenosing atherosclerosis was: anterior interventricular branch – 92.3 %, right coronary artery – 73.1% and circumflex branch – 70.7 %.
Conclusions. It was found that the frequency of multivessel coronary artery lesions in male patients was 88.4 % and was significantly higher compared to the corresponding frequency in women – 83.4 %, (χ²=18.91; p=0.0001). It was found that the completeness of revascularization of the anterior interventricular branch in male patients was 97.1 %, and in female patients – 87.3 %, which was characterized by a significant difference in frequencies, (χ²=12.10; p=0.001). The completeness of revascularization of the circumflex branch in male patients was 86.3%, while in female patients it was 79.1%, indicating a significantly higher percentage of successful revascularization of the circumflex branch in men compared to women (χ²=37.03; p=0.0001). It was determined that the completeness of revascularization of the right coronary artery in male patients was 89.0%, and in female patients it was 49.3 %, which characterizes a significant prevalence of the completeness of its revascularization in male patients (χ²=809.12; p=0.0001). It was found that the overall average completeness of revascularization in male patients in this study was 90.8 %, and in female patients it was 71.9 % (χ²=286.34; p=0.0001).
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