We report a clinical case of successful simultaneous surgical repair of postinfarction ventricular septal rupture, aneurysm of the right ventricular posterior wall and aneurysm of the left ventricular apex combined with three-vessel coronary artery bypass grafting in a 76-year-old patient .
The article analyses the possibility of using direct bioelectric impedancemetry of the right ven- tricle (RV) as an intra-operation method for evaluation of myocardial protection effectiveness in open-heart surgery. The results of intra-operation monitoring of bioelectric impedancemetry indi- cators of RV in 40 patients underwent surgical treatment with the use of cardioplegia were ana- lyzed. Bioelectrical impedance of myocardium has been studied during the whole period of artificial blood circulation. The analysis of the results showed that the bioelectric myocardium impedancemetry allows to assess the level of the interstitial space filling during the infusion of cardioplegia solution, providing an opportunity to assess the perfusion adequacy and also the level of reperfusion cells damage and myocardium swelling degree at the stage of coronary blood flow restoration. Using the method of myocardium bioelectric impedancemetry we found that blood cardioplegia with the "thermal induction" more reliably protects the myocardium in the period of anoxia in comparison with the cold cardioplegia.
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