Results of surgical revascularization of the anterior interventricular branch using the left internal thoracic artery in high-risk patients and multifocal coronary artery disease
Bibliographic record
Abstract
Objective : to assess the possibility of using mammary coronary bypass without bypass in high-risk patients and multifocal coronary artery disease, to analyze the immediate and long-term postoperative periods, to study clinical features in patient groups. Materials and methods : Th e study included 60 patients. All patients had a high risk of surgical intervention and a complicated pre-operative history. In the fi rst group, despite the multifocal lesion of the coronary arteries, for various reasons, we performed mammary coronary bypass on a working heart. In the second group, all patients underwent aorto-coronary bypass + mammary coronary bypass with bypass in a standard scheme using cold cardioplegia. Later, the results were evaluated aft er 30 days, 1 year, 5 years aft er the intervention. Results: It was showed that the immediate postoperative results and indices during the year had a positive dynamics - the class of angina pectoris decreased, the hemodynamic parameters changed. In addition, the rejection of bypass in patients with a complicated anamnesis made it possible to exclude complications from the excretory and nervous systems that we observed in the second group. In the future, we observed an increase in the class of angina in the fi rst group. Th e recurrence of angina pectoris is associated, in our opinion, with the progression of coronary atherosclerosis, an increase in existing stenoses and the appearance of new stenoses. Conclusions: mammary coronary bypass without bypass can be successfully used in high-risk patients and multifocal lesion of the coronary bed. Th is can be regarded as an outcome with extremely dangerous use of bypass for complete myocardial revascularization. Th e immediate results are positive and minimize postoperative risk from adjacent organs and systems. Anatomical and functional state of mammary coronary bypass is satisfactory, both in the near and the delayed period. Long-term observations indicate an increase in the class of angina and complications of IHD in this group of patients. Th e way out in this situation we see in the combined work of the surgical and endovascular team.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".