Anatomy of the coronary arteries: functions, structure and mechanism of blood supply. Coronary arteries of the heart, diagram of vessels

arteries of the heart move away from aortic bulbs,bulbils aortae, - the initial expanded section of the ascending aorta and, like a crown, surround the heart, in connection with which they are called coronary arteries. The right coronary artery begins at the level of the right sinus of the aorta, and the left coronary artery - at the level of its left sinus. Both arteries depart from the aorta below the free (upper) edges of the semilunar valves, therefore, during contraction (systole) of the ventricles, the valves cover the openings of the arteries and almost do not let blood flow to the heart. With relaxation (diastole) of the ventricles, the sinuses fill with blood, blocking its path from the aorta back to the left ventricle, and at the same time open the access of blood to the vessels of the heart.

right coronary artery,a. corondria dextra, goes to the right under the ear of the right atrium, lies in the coronary sulcus, goes around the right pulmonary surface of the heart, then follows its posterior surface to the left, where it anastomoses with its end with the circumflex branch of the left coronary artery. The largest branch of the right coronary artery is posterior interventricular branch, d.interventionrlculdris posterior, which is directed along the sulcus of the same name towards its apex. The branches of the right coronary artery supply the wall of the right ventricle and atrium, the posterior part of the interventricular septum, the papillary muscles of the right ventricle, the posterior papillary muscle of the left ventricle, the sinoatrial and atrioventricular nodes of the cardiac conduction system.

left coronary artery,a. corondria sinistra, slightly thicker than the right. Located between the beginning of the pulmonary trunk and the auricle of the left atrium, it is divided into two branches: anterior interventricular branch, d.interventriculdrls anterior, and envelope branch, g.circumflexus. The latter, which is a continuation of the main trunk of the coronary artery, goes around the heart on the left, located in its coronary sulcus, where it anastomoses with the right coronary artery on the posterior surface of the organ. The anterior interventricular branch follows the sulcus of the same name towards the apex of the heart. In the region of the cardiac notch, it sometimes passes to the diaphragmatic surface of the heart, where it anastomoses with the terminal section of the posterior interventricular branch of the right coronary artery. Branches of the left coronary artery supply the wall of the left ventricle, including the papillary muscles, most of the interventricular septum, the anterior wall of the right ventricle, and the wall of the left atrium.

The branches of the right and left coronary arteries, connecting, form, as it were, two arterial rings in the heart: transverse, located in the coronary sulcus, and longitudinal, the vessels of which are located in the anterior and posterior interventricular sulci.

Branches of the coronary arteries provide blood supply to all layers of the walls of the heart. In the myocardium, where the level of oxidative processes is the highest, microvessels anastomosing with each other repeat the course of the bundles of muscle fibers of its layers.

There are various options for the distribution of branches of the coronary arteries, which are called types of blood supply to the heart. The main ones are as follows: right coronary, when most parts of the heart are supplied with blood by the branches of the right coronary artery; left coronary, when most of the heart receives blood from the branches of the left coronary artery, and medium, or uniform, in which both coronary arteries evenly participate in the blood supply to the walls of the heart. There are also transitional types of blood supply to the heart - middle right and middle left. It is generally accepted that among all types of blood supply to the heart, the middle right type is predominant.

Variants and anomalies of the position and branching of the coronary arteries are possible. They are manifested in changes in the places of origin and the number of coronary arteries. So, the latter can depart from aopfbi directly above the semilunar valves or much higher - from the left subclavian artery and not from the aorta. The coronary artery may be the only one, i.e., unpaired, there may be 3-4 coronary arteries, and not two: two arteries depart to the right and left of the aorta, or two from the aorta and two from the left subclavian artery.

Along with the coronary arteries, non-permanent (additional) arteries go to the heart (especially to the pericardium). These can be mediastinal-pericardial branches (upper, middle and lower) of the internal thoracic artery, branches of the pericardial phrenic artery, branches extending from the concave surface of the aortic glans, etc.

Veins of the heart more numerous than arteries. Most of the large veins of the heart are collected in one common wide venous vessel - coronary sinus,sinus corondrius (remnant of the embryonic left common cardinal vein). The sinus is located in the coronary sulcus on the posterior surface of the heart and opens into right atrium below and anterior to the opening of the inferior vena cava (between its valve and the interatrial septum). The tributaries of the coronary sinus are 5 veins: 1) a large vein of the heart,v. cordis [ cardldca] magna, which begins in the region of the apex of the heart on its anterior surface, lies in the anterior interventricular sulcus next to the anterior interventricular branch of the left coronary artery, then turns to the left at the level of the coronary sulcus, passes under the circumflex branch of the left coronary artery, lies in the coronary sulcus on the posterior surface of the heart, where it continues into the coronary sinus. The vein collects blood from the veins of the anterior surface of both ventricles and the interventricular septum. The veins of the posterior surface of the left atrium and left ventricle also flow into the large vein of the heart; 2) middle vein of the heart,v. cordis [ cardidca] media, formed in the region of the posterior surface of the apex of the heart, rises up the posterior interventricular groove (adjacent to the posterior interventricular branch of the right coronary artery) and flows into the coronary sinus; 3) small vein of the heartv. cordis [ cardidca] pdrva, begins on the right pulmonary surface of the right ventricle, rises up, lies in the coronary groove on the diaphragmatic surface of the heart and flows into the coronary sinus; it collects blood mainly from the right half of the heart; four) posterior vein of the left ventricleand.posterior ventriculi sinistri [ v. ventriculi sinistri posterior], it is formed from several veins on the posterior surface of the left ventricle, closer to the apex of the heart, and flows into the coronary sinus or into a large vein of the heart; 5) oblique vein of the left atrium,v. obliqua dtrii sinistri, follows from top to bottom along the posterior surface of the left atrium and flows into the coronary sinus.

In addition to the veins that flow into the coronary sinus, the heart has veins that open directly into the right atrium. it anterior veins of the heartUV. cordis [ cardidcae] anteriorcs, collecting blood from the anterior wall of the right ventricle. They travel upward to the base of the heart and open into the right atrium. smallest veins of the heart(tebezian veins) vv. cordis [ cardidcae] minimae, only 20-30, begin in the thickness of the walls of the heart and flow directly into the right atrium and partially into the ventricles and left atrium through openings of the smallest veins,foramina vendrum minimdrum.

Lymphatic bed The wall of the heart consists of lymphatic capillaries located in the form of networks in the endocardium, myocardium and epicardium. Lymph from the endocardium and myocardium flows into the superficial network of lymphatic capillaries located in the epicardium and the plexus of lymphatic vessels. connecting with each other, lymphatic vessels enlarge and form two main vessels of the heart, through which the lymph flows to the regional lymph nodes. Left lymphatic vessel The heart is formed from the fusion of the lymphatic vessels of the anterior surfaces of the right and left ventricles, the left pulmonary and posterior surfaces of the left ventricle. It follows from the left ventricle to the right, passes behind the pulmonary trunk and flows into one of the lower tracheobronchial lymph nodes. Right lymphatic vessel The heart is formed from the lymphatic vessels of the anterior and posterior surfaces of the right ventricle, goes from right to left along the anterior semicircle of the pulmonary trunk and flows into one of the anterior mediastinal lymph nodes located near the arterial ligament. Small lymphatic vessels, through which lymph flows from the walls of the atria, flow into the nearby anterior mediastinal lymph nodes.

coronary arteries are vessels that provide the heart muscle with the necessary nutrition. Pathologies of these vessels are very common. They are considered one of the main causes of death in the elderly.

The scheme of the coronary arteries of the heart is branched. The network includes large branches and a huge number of small vessels.

The branches of the arteries originate from the aortic bulbs and go around the heart, providing an adequate supply of blood. different areas hearts.

Vessels consist of endothelium, muscular fibrous layer, adventitia. Due to the presence of such a number of layers, the arteries are characterized by high strength and elasticity. This allows blood to move normally through the vessels even if the load on the heart is increased. For example, during training, when athletes' blood moves five times faster.

Types of coronary arteries

The entire arterial network consists of:

• main vessels;
• adnexal.

The last group includes such coronary arteries:

1. Right. She is responsible for the flow of blood to the cavity of the right ventricle and the septum.
2. Left. From her blood comes to all departments. It is divided into several parts.
3. bending branch. It departs from the left side and provides nutrition to the septum between the ventricles.
4. Anterior descending. Thanks to it, nutrients enter different parts of the heart muscle.
5. Subendocardial. They pass deep into the myocardium, and not on its surface.

The first four views are located on top of the heart.

Types of blood flow to the heart

There are several options for blood flow to the heart:

1. Right. This is the dominant view if this branch originates from the right artery.
2. Left. This method of nutrition is possible if the posterior artery is a branch of the circumflex vessel.
3. Balanced. This type is isolated if blood flows simultaneously from the left and right arteries.

Most people have the right type of blood supply.

Possible pathologies

The coronary arteries are blood vessels that provide vital important organ enough oxygen and nutrients. The pathologies of this system are considered one of the most dangerous, as they gradually lead to more serious illnesses.

angina pectoris

The disease is characterized by attacks of suffocation with severe pain in the chest. This condition develops when the vessels are affected by atherosclerosis and the heart does not receive enough blood.

Pain is associated with oxygen starvation of the heart muscle. Physical and mental stress, stress and overeating aggravate the symptoms.

myocardial infarction

This is a dangerous problem in which certain parts of the heart die. The condition develops when the blood supply stops completely. This usually occurs when the coronary arteries of the heart are clogged with a blood clot. Pathology has vivid manifestations:

The area that was subject to necrosis can no longer contract, but the rest of the heart works as before. Because of this, the damaged area may rupture. Lack of medical assistance will lead to the death of the patient.

Causes of defeat

Damage to the coronary arteries in most cases is associated with insufficient attention to the state of one's own health.

Every year, such violations lead to the death of millions of people around the world. At the same time, most people are residents of developed countries and are well off.

The provoking factors contributing to violations are:

Not less than important influence render age-related changes, hereditary predisposition, gender. Such diseases are acute form affect men, so they die from them much more often. Women are more protected due to the influence of estrogen, so they are more likely to have a chronic course.

coronary arteries

stomach and heart. - B. arteries of the stomach(arteriae coronariae ventriculi) depart from the celiac artery (art. coeliaca) or its branches ( hepatic artery, splenic, etc.). There are four of them; of these, two are connected at the lesser curvature of the stomach and thus form the upper arterial arch of the stomach (arcus arteriosus ventriculi superior); the other two, merging at the greater curvature, form the lower arterial arch of the stomach. A mass of small branches depart from both arterial arches, which enter the wall of the stomach and here break up into the smallest blood stems. B. artery heart (arteria coronaria cordis) - a branch that gives the main vascular trunk of the body (see Aorta), while still in the cavity of the pericardial sac. Starting with two openings lying approximately at the same height as the free edge of the aortic semilunar valves, two V. arteries depart from the expanded part of the latter, called the bulb, and go to the anterior surface of the heart, to its transverse groove. Here, both V. arteries diverge: the right one goes to the right edge of the heart, bends around it, passes to the back surface and along the posterior longitudinal groove reaches the apex of the heart, into the tissue of which it enters; the left gives first a large branch, reaching along the anterior longitudinal groove to the apex of the heart, then goes to the left edge of the heart, passes to the back and here, at the height of the transverse groove, enters the muscles of the heart. Throughout its length, both V. arteries give small branches that penetrate into the thickness of the wall of the heart. The right V. artery supplies blood to the walls of the right atrium, the right ventricle, the apex of the heart, and, in part, the left ventricle; left - apex of the heart, left atrium, left ventricle, ventricular septum. If an animal artificially closes or even only narrows the lumen of the V. artery, then after a while the heart stops contracting (cardiac paralysis), since the heart muscle can work correctly only as long as the V. arteries supply it with sufficient blood necessary for nourishment. quantity. On V. arteries human heart meet pathological changes, which affect in a similar way, that is, they completely stop or significantly reduce the blood flow to the walls of the heart (see Arteriosclerosis, Thrombosis, Embolism) and thereby entail instant death or very painful suffering - myocarditis with its consequences (aneurysm, rupture, heart attack), often angina pectoris, and so on.

encyclopedic Dictionary F. Brockhaus and I.A. Efron. - St. Petersburg: Brockhaus-Efron. 1890-1907 .

See what "Coronary arteries" are in other dictionaries:

Trunk arteries - … Atlas of human anatomy

- (Greek, singular artēría), blood vessels that carry oxygenated (arterial) blood from the heart to all organs and tissues of the body (only pulmonary artery carries venous blood from the heart to the lungs). * * * ARTERIES ARTERIES (Greek, singular… … encyclopedic Dictionary

Arteries that supply blood to the heart muscle. The right and left coronary arteries (right and left coronary arteries) depart from the bulb and give off branches that supply the heart. See Coronary angioplasty. Bypass vascular shunt. Source:… … medical terms

CORONARY ARTERIES, CORONARY ARTERIES- (coronary arteries) arteries supplying blood to the heart muscle. The right and left coronary arteries (right and left coronary arteries) depart from the bulb and give off branches that supply the heart. See Coronary angioplasty. Bypass shunt ... ... Dictionary in medicine

Vessels of the heart- Arteries. The blood supply to the heart is carried out by two arteries: the right coronary artery, a. coronaria dextra, and the left coronary artery, a. coronaria sinistra, which are the first branches of the aorta. Each of the coronary arteries comes out of ... ... Atlas of human anatomy

HEART- HEART. Contents: I. Comparative anatomy........... 162 II. Anatomy and histology ........... 167 III. Comparative physiology .......... 183 IV. Physiology .................. 188 V. Pathophysiology ................. 207 VI. Physiology, pat. ... ...

ANGINA PECTORIS- Angina pectoris, (angina pectoris, synonymous with Heberden's asthma), in its essence, is primarily a subjective syndrome, manifesting itself in the form of severe retrosternal pain, accompanied by a sense of fear and a sense of the immediate proximity of death. Story. 21… Big Medical Encyclopedia

In the diagram, the Aorta (lat. arteria ortha, a.ortha direct artery [source not specified 356 days]) is the largest unpaired arterial vessel great circle... Wikipedia

LICHTENBERG- Alexander (Alexander Lich tenberg, born in 1880), an outstanding contemporary German. urologist. He was an assistant to Czerny and Narath. In 1924, he received the head of the urological department in the Catholic church of St. Hedwigs in Berlin, to a swarm in ... ... Big Medical Encyclopedia

The science that studies the structure of the body individual bodies, tissues and their relationships in the body. All living things are characterized by four features: growth, metabolism, irritability and the ability to reproduce themselves. The combination of these signs ... ... Collier Encyclopedia

The heart muscle, unlike other muscles in the body, which are often at rest, works continuously. Therefore, it has a very high oxygen demand and nutrients, which means it needs a reliable and uninterrupted blood supply. The coronary arteries are designed to provide a continuous supply of blood to keep the myocardium working properly.

Myocardial vasculature

Due to the impermeability of the inner walls of the heart (endocardium) and the large thickness of the myocardium, the heart is not deprived of the opportunity to use the blood contained in its own chambers to obtain oxygen and nutrition. Therefore, it has its own blood supply system, consisting of coronary vessels hearts. The two main coronary (coronary) arteries are responsible for the general distribution of blood:

• left (LCA or LCA);
• and right (PCA or RCA).

Both originate from their respective sinuses at the base of the aorta, located behind the aortic valve leaflets, as shown in the diagram of the coronary arteries. When the heart is relaxed, the flow of blood fills its pockets and then enters the coronary arteries. Since the LCA, RCA lie on the surface of the heart, they are called epicardial, their branches, passing deep in the myocardium, are called subepicardial. Most people have two coronary arteries, but about 4% also have a third, called the posterior (it is not shown in the diagram of the arteries of the heart).

The main trunk of the LCA has a lumen diameter often exceeding 4.5 mm and is one of the shortest and most important vessels in the body. As a rule, it has a length of 1 to 2 cm, but can be only 2 mm in length before the division point. The left coronal artery divides into two branches:

• anterior descending or interventricular (LAD);
• envelope (OB).

The left anterior descending (anterior interventricular branch) usually begins as a continuation of the LCA. Its size, length and extent are key factors in balancing the supply of blood to the IVS (interventricular septum), LV (left ventricle), most of both the left and right atria. Passing along the longitudinal cardiac sulcus, it goes to the apex of the heart (in some cases it continues beyond it to the back surface). The lateral branches of the LAD lie on the anterior surface of the LV, feeding its walls.

The OV channel is discharged from the LCA, usually at a right angle, passing along the transverse groove, reaches the edge of the heart, goes around it, passes to the posterior wall of the left ventricle and, in the form of a posterior descending artery, reaches the apex. One of the main branches of the OV is the branches of the obtuse margin (OTC) that feed the lateral wall of the left ventricle.

The lumen (PCA) is about 2.5 mm or more. The anatomical structure of the RCA is individual and determines the types of myocardial blood supply. Critical Role- nutrition of the areas of the heart responsible for regulating heart rate.

Types of blood supply to the heart

The blood flow to the anterior and lateral surfaces of the myocardium is quite stable and is not subject to individual changes. Depending on where the coronary arteries and their branches are located in relation to the back or surface of the myocardial diaphragm There are three types of blood supply to the heart:

• Average. Consists of well-developed LAD, OB and RCA. The blood supply vessels are completely for the LV and from two thirds to a half of the IVS are branches of the LCA. The pancreas and the rest of the IVS are powered by the RCA. This is the most common type.
• Left. In this case, the blood flow in the LV, the entire IVS and part of the posterior wall of the pancreas is carried out by the LCA network.
• Right. Isolate when the pancreas and back wall The LV is powered by the RCA.

These structural changes dynamic, they can be accurately determined only with the help of coronary angiography. There is an important characteristic for cardiac circulation, consisting in the presence of collaterals. This is the name given to the alternative routes formed between the main vessels that can be activated at the moment when, for any reason, the working one is blocked in order to take over the functions of the one that has become unusable. The collateral network is most developed in older people suffering from coronary pathologies.

That is why in critical situations associated with the blockage of the main vessels of the myocardium, young people are at maximum risk.

Disorders in the coronary arteries

Coronary arteries with abnormal structure are not uncommon. People do not have complete identity in the structure of blood circulation both with the standards of anatomy and with each other. Differences arise for many reasons. They can be divided into two groups:

• hereditary;
• acquired.

The former may be the result of abnormal variability, while the latter include the consequences of injuries, operations, inflammation and other diseases. The range of consequences from disorders can be enormous, from asymptomatic to life threatening. Anatomical changes in coronary vessels include their position, direction, number, size, and length. If congenital abnormalities are significant, they make themselves felt even in early age and should be treated by a pediatric cardiologist.

But more often such changes are detected by chance or against the background of another disease. Blockage or rupture of one of the coronary vessels leads to the consequences of deterioration of blood circulation, proportional to the value of the damaged vessel. normal operation the main vessels of the myocardium and problems in their functioning are always reflected in typical clinical symptoms and ECG records.

Problems with blood supply to the myocardium make themselves felt when physical or emotional stress is exceeded. This is especially important to remember because some coronary anomalies may be the reason sudden stop heart in the absence of underlying diseases.

Cardiac ischemia

CAD occurs when the arteries that supply blood to the heart muscle become brittle and narrow due to deposits on the walls. It causes oxygen starvation myocardium. In the 21st century, coronary heart disease is the most common type of heart disease and main reason death in many countries. The main signs and consequences of a reduction in coronary blood flow:

If the reduction or absence of blood flow in the coronary vessels occurs due to stenotic damage to the vessel, then blood supply can be restored using:

If the lack of blood flow is caused by blood clots (thrombosis), then the administration of drugs that dissolve clots is used. Aspirin and antiplatelet drugs are used to prevent recurrence of thrombosis.

Diseases of the heart and associated vascular system in this moment have become a huge problem of modern human civilization. At the same time, the more prosperous the society is in terms of living standards, the more serious the situation is in terms of the number of people suffering from coronary heart disease.

What is coronary heart disease?

The human heart is a very complex, finely tuned and sensitive mechanism, the purpose of which can be reduced to one function - the delivery of substances necessary for proper functioning to each cell of the body.

In addition to the heart itself, blood vessels also participate in this activity, the system of which permeates the human body, which fully ensures the uninterrupted delivery of everything necessary to the cells of the organs most distant from the heart.

Crown

lar artery and its role in the human life support system

The full functioning of this system is ensured by the heart muscle, the rhythm and completeness of contractions of which also depend on the normal supply of blood - the carrier of everything necessary for normal life. human body. Blood flows to the heart muscle through vessels called coronary arteries.

Hence the names: artery, etc. And if the required blood flow in the coronary arteries is reduced, the heart muscle is deprived of nutrition, which leads to coronary diseases such as heart failure, abnormal heart rhythms and heart attacks. The reason for everything is coronary atherosclerosis.

What is it and why is it scary?

Over time and under the influence of many factors, which will be discussed later, fats and lipids settle on the walls of the arteries, forming constantly growing sticky plaques that create obstacles to normal blood flow.

Thus, the lumen of the artery gradually decreases, and less and less oxygen is supplied to the heart, which leads to the appearance of pain in the retrosternal region - angina pectoris. At first, these pains can disturb a person only during heavy exertion, but gradually they become a response to even small efforts, and subsequently they can also occur at rest.

Complications and concomitant diseases of atherosclerosis

Atherosclerosis of the coronary arteries inevitably leads to such a disease as the heart. It is worth noting that the so-called heart diseases claim incomparably more lives than oncological or infectious diseases- and it is in the most developed countries.

Damage to the coronary arteries naturally It has a negative effect on the heart muscle, which, in turn, causes angina pectoris, heart attacks, heart attacks, heart rhythm disturbances, heart failure and, worst of all, cardiac death.

Symptoms in coronary heart disease

The human body has an individual anatomical structure. And the anatomy of the heart, the arteries that feed it, each has its own characteristics. The heart is fed by two coronary arteries - right and left. And it is the left coronary artery that provides the heart muscle with oxygen in the amount required for its normal functioning.

With a decrease in blood flow in it, retrosternal pain occurs - symptoms of angina pectoris, and their appearance is often not associated with special loads. A person can experience them both while at rest, such as in sleep, and while walking, especially over rough terrain or stairs. Such pains can also be provoked by weather conditions: in winter, in cold and windy weather, they can disturb more often than in summer.

What you need to know about angina pectoris

First of all, this disease is the result of acute heart failure, provoked by insufficient blood supply to the heart muscle due to the fact that the left coronary artery is affected. Another name for the disease, known to many from Russian classical literature, is angina pectoris.

A characteristic manifestation of this disease is the pain already described earlier. But it is also possible (most often on initial stages) sensations not of pain as such, but of pressure in the chest, burning. Moreover, the amplitude of pain has a fairly wide range: from almost insignificant to unbearably acute. Its distribution area is located mainly on the left side of the body and rarely on the right. Pain may appear in the arms, shoulders. Affect the neck and lower jaw.

Pain is not constant, but paroxysmal, and their duration is mainly from 10 to 15 minutes. Although there are up to half an hour - in this case, a heart attack is possible. Attacks can be repeated with an interval of 30 times a day to once a month or even years.

Factors Contributing to the Development of Coronary Heart Disease

As mentioned earlier, coronary heart disease is the result of damage to the coronary arteries. There are several generally recognized factors in which the coronary artery that feeds the heart muscle becomes unusable.

The first of these can rightly be called redundantly high level in human blood cholesterol, which, due to its viscosity, is the root cause of the formation of plaques on the walls of the artery.

The next risk factor contributing to the development of heart disease, namely heart attack, is hypertension - excess blood pressure.

Huge damage to the coronary arteries of the heart is obtained from smoking. The risk of damage to the walls of the arteries increases many times due to the harmful effects on them chemical compounds that make up tobacco smoke.

The next risk factor that increases the likelihood of coronary artery disease is a disease such as diabetes. With this disease, atherosclerosis is exposed to the entire vascular system human, and significantly increases the likelihood of heart disease at an earlier age.

Heredity can also be attributed to risk factors affecting the occurrence of heart disease. Especially if the fathers of potential patients had heart attacks or died as a result of coronary diseases before the age of 55, and mothers before the age of 65.

Prevention and treatment of coronary heart disease

It is possible to avoid or reduce the risk of getting coronary heart disease if you perform, and strictly and continuously, several simple recommendations, which include healthy lifestyle life, rejection bad habits, reasonable physical exercise and annual check-ups.

Treatment of coronary heart disease includes several options: drug therapy and cardiac surgery. The most common is coronary artery bypass grafting, in which blood is directed to the heart muscle along a bypass route: along a segment sewn parallel to the affected area of ​​the aorta healthy vessel taken from the patient himself. The operation is complex, and after it the patient needs a long period of rehabilitation.

Another type of treatment is angioplasty of the coronary artery using a laser. This option is more gentle and does not require dissection of large segments of the body. The affected area of ​​the coronary artery is reached through the vessels of the shoulder, thigh or forearm.

Unfortunately, no matter what operations are performed, even the most successful of them do not get rid of atherosclerosis. Therefore, in the future it is necessary to comply with all medical prescriptions, this applies not only medical preparations but also the recommended diet.