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Objectives – to evaluate the efficacy of different types of risk reducing cardioprotection preceding the open surgery on the abdominal aorta. Material and methods. The study analyses the treatment outcomes in 262 patients with abdominal aortic aneurysm. In all the patients the operation of prosthetics of abdominal aorta was performed. The patients were divided in two groups depending on the method of preoperative cardioprotection. The first group included 158 patients who received the intensive medicamentous preparation for the surgery. The second group of 104 patients additionally to drug treatment underwent the stress EchoCG; the coronarography was performed in patients with the positive test result. If the coronarography revealed the significant impairment of the coronary artery, the preliminary cardioprotective operations were performed: myocardial revascularization in 24 patients, CABG in 5 patients and coronary stenting in 19 cases. Results.In spite of the intensive medicamentous preoperative preparation, in the first group the rate of myocardial infarction and acute coronary syndrome outcomes was significantly higher than in the second group of patients, who received the different preliminary myocardial revascularization according to individual requirements. Conclusion.The individual approach to the choice of cardioprotection method before abdominal aortic aneurysm surgery significantly reduces the adverse cardiac events rate.

The study focuses on the outcomes of surgical treatment of 236 patients with critical ischemia of lower limbs originating from aortoiliac lesions and concomitant coronary artery disease. All patients first underwent vascular surgery, with 158 of them having aortobifemoral bypass surgery and 78 - hybrid vascular procedures on the aortoiliac segment: open surgical revascularization of femoral arteries and angioplasty and stenting of iliac arteries. Critical limb ischemia was successfully treated in all patients. One patient died after aortobifemoral bypass surgery; no fatal outcomes were registered after hybrid procedures.