The immediate results of coronary artery bypassgrafting, depending on revascularizationat simultaneous interventions on brachiocephalicarteries

Authors: A.A. Melikulov, V.Yu. Merzlyakov, I.V. Klyuchnikov, A.I. Skopin, N.A. Darvish, S.K. Mamedova, M.F. Akhmedova, A.K. Zhalilov, M.A. Salomov

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

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DOI: https://doi.org/10.24022/1997-3187-2017-11-4-304-314

For citation: Melikulov A.A., Merzlyakov V.Yu., Klyuchnikov I.V., Skopin A.I., Darvisch N.A., Mamedova S.K., khmedovа M.F., Zhalilov A.K., Salomov M.A. The immediate results of coronary artery bypass grafting, depending on revascularization at simultaneous interventions on brachiocephalic arteries. Kreativnaya Kardiologiya (Creative Cardiology). 2017; 11 (4): 304–14 (in Russ.). DOI: 10.24022/1997-3187-2017-11-4-304-314

Received / Accepted:  16.10.2017/30.10.2017

Keywords: myocardial revascularization ischemic heart disease stroke carotid endarterectomy

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Abstract

Objective. Comparison of immediate results of one-stage operations on brachiocephalic and coronary arteries in patients with high surgical risk in performing on pump coronary artery bypass and off pump coronary artery bypass.

Material and methods. The study included 309 patients, divided into two groups. In group 1, 169 patients underwent simultaneous intervention with coronary bypass surgery on the operating heart and carotid endarterectomy. Accordingly, 140 patients in group 2 underwent conventional coronary artery bypass graft (CABG) and carotid endarterectomy. For all clinical parameters, the patients of both groups were statistically comparable and did not differ significantly.

Results.
Therefore, the total duration of the operation was 6.22±1.5 h in the first off pump coronary bypass group, 5.9±1.3 h in the second group conventional CABG, and did not differ significantly (p=0.072). The frequency of cerebrovascular complications in both groups did not have a statistically significant difference. Hospital mortality in the I group was 4.7% (8 cases), and in the second group – 9.3% (13 cases) (p=0.1235). In the off pump coronary bypass group, single-stage intervention revealed a statistically significant benefit in terms of the frequency of the need for hemodialysis, the need for prolonged ventilation, as well as for a set of complications in the form of a primary endpoint (death + myocardial + stroke + hemodialysis + redo bypass).

Conclusions. Thus, in the presence of indications for performing simultaneous operations on coronary and brachiocephalic arterial pools in patients with high surgical risk, off pump coronary artery bypass is a justified method with an acceptable profile of efficacy and safety in a specialized hospital with an experienced surgeon and a trained operating team.

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About Authors

  • Melikulov Alisher Almardonovich, Cand. Med. Sc., Cardiac 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;
  • Skopin Anton Ivanovich, Cand. Med. Sc., Leading Researcher, orcid.org/0000-0002-4463-0755;
  • Darvish Nedal Akhmedovich, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-2152-4730;
  • Mamedova Sevindzh Kamilovna Kizy, Cand. Med. Sc., Junior Researcher, orcid.org/0000-0002-5696-0807;
  • Akhmedova Madina Fatkhullaevna, Cand. Med. Sc., Cardiologist, orcid.org/0000-0002-6184-6742;
  • Zhalilov Adkham Kakhramonovich, Cand. Med. Sc., Applicant, orcid.org/0000-0002-0364-6371;
  • Salomov Makhmadsharif Abdusamadovich, Applicant, orcid.org/0000-0002-8602-3152

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