Physiological Evaluation of the Results of Myocardial Revascularization in Patients with Ischemic Heart Disease

Intraoperative assessment of the myocardial blood flow was performed in different heart areas in 94 patients with ischemic heart disease prior to and after myocardial revascularization. An ALF-21 laser–Doppler flowmeter (Transonic Systems Inc.) was used to measure the myocardial blood flow near the anterior and posterior surfaces of the left ventricle (LV_asand LV_ps, respectively) and the anterior surface of the right ventricle (RV_as). According to the results of revascularization, the patients were divided into four groups: group I with increased myocardial blood flow in all areas tested, group II and group III with blood flow redistributed along LV and RV, and group IV with moderately decreased myocardial blood flow in all test areas. All groups showed a postoperative decrease in blood flow differences between different myocardium areas and the leveling of blood flow in the whole myocardium. The efficiency of revascularization depended on a number of factors, including the initial level of myocardial blood flow, completeness of revascularization of ischemic areas, the number and quality of bypass grafts, and the patients' age. The most pronounced positive results were observed in patients under the age of 60 years.