Practical Guidelines

Surgical treatment of the ischemic cardiomyopathy. Role of the myocardial viability

O.I. Zharinov¹, A.V. Pinchuk², Ye.V. Shnyrkova², V.A. Kuts¹, Khorram Sohrab², V.Yu. Kundin², O.V. Zelenchuk², B.M. Todurov²

¹ Shupyk National Medical Academy of Postgraduate Education of Healthcare Ministry of Ukraine, Kyiv, Ukraine

² Kyiv City Heart Center

Evaluation of the myocardial viability is one of the key elements of investigation of patients with ischemic heart disease and decreased left ventricular (LV) ejection fraction before planned surgical revascularization. The restoration of the blood supply of the viable segments improves LV function, decreases symptoms of heart failure, prevents life-threatening ventricular arrhythmias, fatal and non-fatal cardiovascular events. Therefore, preserved viability of myocardium supplied by the stenosed coronary artery is one of the clear indications for surgical or endovascular revascularization in the contemporary guidelines. The clinical case of coronary artery bypass grafting in the patient with severely decreased LV ejection fraction and preserved myocardial viability is discussed.

Key words: ischemic heart disease, left ventricular dysfunction, myocardial viability, coronary artery bypass grafting