CHANGES IN MYOCARDIAL STRUCTURE AND FUNCTION AFTER CORONARY ARTERY BYPASS SURGERY

Abstract

Cardiovascular disease remains the leading cause of death, and coronary bypass grafting is one of the most effective methods of surgical revascularization of the myocardium in cases of multivascular coronary artery disease. However, the restoration of coronary blood flow is not always accompanied by a complete structural and functional restoration of the heart muscle. The article examines the clinical and morphological changes in the myocardium in the early and long-term postoperative periods after coronary bypass grafting. Particular attention was paid to the phenomenon of "blinded myocardium," ischemic-reperfusion damage, cardiomyocyte apoptosis, and the development of fibrotic changes. It has been shown that, despite improved coronary perfusion and clinical reduction of ischemia symptoms, some patients retain microcirculation disorders and signs of chronic myocardial remodeling. The importance of morphological and ultrastructural changes in the heart muscle in assessing the effectiveness of coronary bypass grafting and predicting postoperative outcomes, as well as the prospects of surgical revascularization methods on a working heart to reduce the severity of myocardial damage, is emphasized.