MODERN STRATEGIES FOR MYOCARDIAL REVASCULARIZATION IN CORONARY HEART DISEASE: OVERVIEW AND PROSPECTS

Coronary heart disease (CHD) remains the leading cause of death and disability worldwide. In conditions of multivessel coronary artery disease, the choice of the optimal revascularization strategy becomes a key factor affecting the prognosis and quality of life of patients. Modern methods, including coronary artery bypass grafting (CABG), percutaneous coronary interventions (PCI), hybrid revascularization and minimally invasive approaches, are actively developing due to technological progress and international clinical research. The presented review analyzes current data from foreign and domestic sources, including the recommendations of ESC/EACTS 2018, the results of major studies (FAME, ISCHEMIA, SYNTAX, EXCEL, ROMA, etc.) and new approaches to individualization of therapy. The issues of assessing anatomical complexity, adequacy of revascularization, choice of shunts and stents, as well as the importance of hemodynamic navigation (FFR/iFR) in making clinical decisions are discussed.