TACTICS OF CORONARY ARTERY BYPASS GRAFTING IN CAD PATIENTS WITH DIFFERENT LEVELS OF SURGICAL RISK
https://doi.org/10.21886/2219-8075-2014-4-35-41
Abstract
Purpose: to study the results of coronary artery bypass grafting (CABG) in patients with ischemic heart disease.
Material and methods: the results of 622 patients with ischemic heart disease from the surgical ward were analyzed. Patients were divided into groups according to the level and character of surgical risk. Hospital mortality rate, frequency of perioperative complications and a range of time indices were taken into consideration.
Results: the postoperative period went smoothly in patients with low surgical risk, regardless of the method used in performing the operation. On-pump coronary artery bypass grafting beating heart in patients with postinfarction myocardial disability resulted in a decline in the frequency of perioperative complications. Collected data points to an obvious advantage of off-pump coronary bypass grafting in patients with severe comorbidity.
Summary: no method of coronary bypass grafting has an absolute advantage over the others. Each of them should be taken into consideration as the optimal variant of operation only after evaluating all clinical and diagnostic indicators.
Material and methods: the results of 622 patients with ischemic heart disease from the surgical ward were analyzed. Patients were divided into groups according to the level and character of surgical risk. Hospital mortality rate, frequency of perioperative complications and a range of time indices were taken into consideration.
Results: the postoperative period went smoothly in patients with low surgical risk, regardless of the method used in performing the operation. On-pump coronary artery bypass grafting beating heart in patients with postinfarction myocardial disability resulted in a decline in the frequency of perioperative complications. Collected data points to an obvious advantage of off-pump coronary bypass grafting in patients with severe comorbidity.
Summary: no method of coronary bypass grafting has an absolute advantage over the others. Each of them should be taken into consideration as the optimal variant of operation only after evaluating all clinical and diagnostic indicators.
About the Authors
I. V. Zhbanov
Russian scientific center surgery named acad. BV Petrovsky
Russian Federation
Russian Federation
R. V. Sidorov
Rostov State Medical University
Russian Federation
Russian Federation
References
1. Бокерия Л.А. Ишемическая болезнь сердца и факторы риска (сравнение показателей в странах Европы, США и России) / Л.А. Бокерия [и др.] // Грудная и сердечно-сосудистая хирургия. – 2007. – № 4. – С. 6–10.
2. Козлов Б.Н., Шипулин В.М., Вечерский Ю.Ю., Ахмедов Ш.Д., Кузне-цов М.С. Эффективность коронарного шунтирования на работающем сердце и в условиях искусственного кровообращения у пациентов группы низкого риска // Кардиология и сердечно-сосудистая хирургия. – 2009. – № 3. – С. 19–24.
3. Шумаков Д.В., Кузьмина И.М., Киладзе Е.С., Шевченко А.О. Отдаленные результаты реваскуляризации миокарда в условиях искусственного кровообращения у больных ишемической болезнью сердца // Вестник трансплантологии и искусственных органов. – 2006. – № 1. – С. 20–24.
4. Акчурин Р.С., Ширяев А.А., Лепилин М.Г. Многососудистое коронарное шунтирование на работающем сердце у больных с ишемической дисфункцией миокарда левого желудочка // Грудная и сердечно-сосудистая хирургия. – 2007. – № 5. – С. 24–27.
5. Бокерия Л.А., Алекян Б.Г., Бузиашвили Ю.И. Результаты операций реваскуляризации миокарда на работающем сердце и аортокоронарного шунтирования с искусственным кровообращением у больных с инфарктом миокарда // Клиническая физиология кровообращения. – 2008. – № 1. – С. 16 – 23.
6. Bulat C., Alfirević I., Korda Z.A., Protrka N., Novkoski M., Predrijevac M. Combined surgical approach to carotid and coronary artery disease // CollAntropol. – 2008, Mar. – Vol. 32, № 1. – P. 209–216.
7. Chen Y.Y., Wang J.F., Zhang Y.J., Xie S.L., Nie R.Q. Optimal strategy of coronary revascularization in chronic kidney disease patients: A meta-analysis // Eur J. Intern. Med. – 2013, Apr. 17. – P. 0953–0955.
8. Sergeant P. et al. OPCAB versus early mortality and morbidity: an issue be-tween clinical relevance and statistical significance // Europ. J. Cardiothorac. Surg. – 2004. – Vol. 25. – P. 779–785.
9. Pillai J.B., Suri R.M. Coronary Artery Surgery and Extracorporeal Circula-tion: The Search for a New Standard // Journal of Cardiothoracic and Vascu-lar Anesthesia. – 2008. – Vol. 22, № 4. – Р. 594–610.
Review
For citations:
Zhbanov I.V., Sidorov R.V. TACTICS OF CORONARY ARTERY BYPASS GRAFTING IN CAD PATIENTS WITH DIFFERENT LEVELS OF SURGICAL RISK. Medical Herald of the South of Russia. 2014;(4):35-41. (In Russ.) https://doi.org/10.21886/2219-8075-2014-4-35-41
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