Abstract:

Aim: was to assess the frequency, predominant localization and severity of atherosclerotic plaques in coronary arteries according to multidetector computed tomography (MDCT) in patients with suspicion on coronary heart disease (CHD).

Materials and methods: analysis of results of CT of coronary arteries (CT-CA) was carried out in 1590 patients. The average age was 53,9 ± 10,7 years. The number of men was 1133 (71,3%). Studies were carried out on 64- and 256-slice CT scanners.

Results: in patients with suspicion on coronary artery disease, atherosclerotic lesions of coronary arteries (CA) were not detected in 582 (36,6%) cases. Minimal and initial CA stenoses were observed in 80 (5%) and 416 (26,2%) patients, respectively. Moderate CA stenoses were found in 236 (14,8%) patients. Severe coronary artery stenoses were detected in 183 patients (11,5%). CA occlusions were observed in 84 (5,3%) cases. Most often, the stenotic process was detected in proximal segments of coronary arteries, in particular, in the left anterior descending artery.

Conclusions: MDCT makes it possible to determine in detail the severity and nature of atherosclerotic coronary lesions, as well as to assess the predominant location of plaques.

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Abstract:

Background. Significant coronary artery disease (CAD), occurring in 7-10% of patients with obstructive hypertrophic cardiomyopathy (HCM), deteriorates the clinical course and survival rates. Until recently, such combination of abnormalities was an indication for coronary artery bypass graft (CABG) and septal myoseptecmy

Aim: was to investigate the efficacy, safety and technique of combined percutaneous intervention in patients with obstructive HCM and CAD. Materials and methods. We have performed 15 combined percutaneous interventions: alcohol septal ablation (ASA) and coronary revascularization. All patients had a marked asymmetric hypertrophy of LV with outflow tract obstruction at rest, as well as severe coronary lesions (75% - 95%). During the procedure, we performed consistently ASA of target zone in charge of obstruction and coronary stenting (10 stents in LAD, 8 stents in RCA, 4 stents in LCX).

Results. Among the effects of interventions were disappearance of angina pectoris and dyspnea, reduction of the pressure gradient in the LV outflow tract and a significant decrease in the thickness of septum. No serious complications (such as MI, complete av-block, ventricular tachiarrhythmias) occured

Conclusion. These results indicate efficacy and safety of ASA combined with coronary revascularization in patients with obstructive HCM who have concomitant CAD.

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