FIELD: medicine; cardiology; cardiovascular surgery.
SUBSTANCE: proposed method is carried out in three stages. At the first stage, the indexed end diastolic volume of the left atrium (iDV LA) is calculated using the echocardiographic study (EchoCG) as the ratio of iDV LA to the body surface area (BSA), determined by the Dubois method. To determine the type of left ventricular (LV) geometry, the thickness of the interventricular septum, the thickness of the posterior wall of the left ventricle and the end-diastolic size of LV (LV EDS) are measured. After this, based on the patient’s anthropometric data, the indexed LV myocardial mass (iMMLV) is calculated as the ratio of LV myocardial mass to BSA, determined in turn using the Dubois method. Then the type of LV geometry is determined by calculating the relative thickness index (RTI) of the LV using the formula. At the second stage, when connecting the heart-lung machine, intraoperatively, a part of the right atrial (RA) appendage is taken. At the third stage, to verify the degree of interstitial fibrosis using light microscopy in 10 fields of view on a 4-point scale, a biopsy sample of the appendage of the RA is examined, with a value of 0, the absence of perivascular fibrosis is diagnosed, with a value of 1, minor perivascular fibrosis is diagnosed, with a value of 2, moderate perivascular fibrosis and interstitial fibrosis are diagnosed, with a value of 3, severe perivascular and interstitial fibrosis are diagnosed, after which the probability of developing postoperative atrial fibrillation (POAF) is calculated using the calculation formula. The probability of developing postoperative atrial fibrillation (M) is calculated using the formula and based on it at the value of M≥0.352, a high risk of developing POAF is predicted, and at the value of M<0.352, a low risk of developing POAF is predicted.
EFFECT: proposed method makes it possible to increase the reliability of predicting the risk of developing POAF after coronary artery bypass surgery in routine clinical practice.
1 dwg, 7 ex
