The influence of preserved carotid sinus nerves on vegetation regulation and central hemodynamic after carotid reconstructions

Relevance. Оne of the most important risk factor after carotid reconstructions of acute myocardial infarction, hyperperfusion syndrome, postoperative hematomas is arterial hypertension.

Aim: to investigate the influence of carotid sinus nerves damage on postoperative arterial hypertension after carotid reconstructions and to compare clinical results with data of rhythmocardiography.

Material and methods: the retrospective analyze of treatment of 310 patients have done. The patients were divided into two groups. The first group included 177 patients with intersected carotid sinus nerves. The second group included 133 patients with preserved carotid sinus nerves. The second part of our study was a prospective evaluation of peripheral autonomic regulation of 13 patients from first group and 17 patients from second group by high-precision analysis of heart rate variability.

Results. On the first postoperative day in the group where the carotid sinus nerves were kept all the blood pressure (systolic, diastolic, pulse pressure), and heart rate were significantly lower than in the other group (p<0.05), with a tendency to restore on the 3rd day. This reduced number of postoperative complications. In patients with preserved carotid sinus nerves by rhythmocardiography marked lower sympathetic activity and higher activity of the parasympathetic system.

Conclusion. The implementation of glomus-preserving operations on the carotid arteries reduces the risk of postoperative hypertension and complications of early postoperative period.