Short-term results of coronary artery bypass grafting on a beating heart in patients older than 70 years with multi-vessel coronary lesions

Authors: A.A. Melikulov, V.Yu. Merzlyakov, I.V. Klyuchnikov, S.K. Mamedova, R.K. Baychurin, M.F. Akhmedova

Company: Bakoulev National Scientific and Practical Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Type:  Ischemic heart disease


DOI: https://doi.org/10.24022/1997-3187-2017-11-3-212-221

For citation: Melikulov A.A., Merzlyakov V.Yu., Klyuchnikov I.V., Mamedova S.K., Baychurin R.K., Akhmedova M.F. Short-term results of coronary artery bypass grafting on a beating heart in patients older than 70 years with multi-vessel coronary lesions. Kreativnaya Kardiologiya (Creative Cardiology). 2017; 11 (3): 212–21 (in Russ.). DOI:10.24022/1997-3187-2017-11-3-212-221

Received / Accepted:  June 8, 2017 / June 15, 2017

Keywords: Melikulov A.A. Merzlyakov V.Yu. Klyuchnikov I.V. Mamedova S.K. Baychurin R.K. Akhmedova M.F.

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Abstract

Objective. Evaluation of early post-operative results of coronary bypass grafting in patients with ischemic heart disease over 70 years with high surgical risk operated by off-pump or on-pump techniques.

Material and methods. This study included 773 patients older than 70 years with multi-vessel coronary artery disease. 405 patients were operated using off-pump coronary artery bypass (OPCAB), and 368 patients with onpump techniques. The average age of patients in OPCAB group was 74.7±3.7 years old, in the on-pump group 75.2±3.5 years old (р=0,068). Preoperative risk stratification was performed by EuroSCORE and EuroSCORE II scales, which had no significant difference between groups.

Results. Mortality in OPCAB group was 3.2% (13 patients), in on-pump group 6.8% (25 patients) (р=0.023). The main combo end point was death, acute myocardial infarction, stroke, acute renal failure with hemodialysis, repeat myocardial revascularization. At early postoperative period end point was 10.3% at on-pump group, and 4.9% at OPCAB group, the difference was statistically significant (р=0.005). Moreover the frequency of acute renal failure occurrence requiring hemodialysis and stroke in on-pump group was more than 3 times higher than in the OPCAB group.

Сonclusion. Performing coronary artery bypass grafting on a beating heart in patients older than 70 years is an effective, safe and a justifiable method that leads to a decrease in the incidence of deaths and postoperative complications, such as acute myocardial infarction, acute renal failure, stroke, in comparison to on-pump surgery.

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About Authors

  • Melikulov Alisher Almardonovich, Cand. Med. Sc., Cardiovascular Surgeon, orcid.org/0000-0002-5164-9702;
  • Merzlyakov Vadim Yur’evich, Dr. Med. Sc., Head of Department, orcid.org/0000-0001-5638-3723;
  • Klyuchnikov Ivan Vyacheslavovich, Dr. Med. Sc., Professor, Chief Researcher, orcid.org/0000-0002-8652-9639;
  • Mamedova Sevindzh Kamilovna kizy, Cand. Med. Sc., Junior Researcher, orcid.org/0000-0002-5696-0807;
  • Baychurin Renat Kamil’evich, Cardiovascular Surgeon, orcid.org/0000-0001-6288-3724;
  • Akhmedova Madina Fatkhullaevna, Cand. Med. Sc., Cardiologist, orcid.org/0000-0002-6184-6742

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery