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Immediate results of complete conventional and bimammary bypass grafting in patients with multivessel coronary disease

Authors: Muradov A.G., Drobot D.B., Grinshteyn Yu.I., Sakovich V.A., Andin A.V.

Company: 1Federal Center for Cardiovascular Surgery, Krasnoyarsk, Russian Federation
2Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2022-16-3-355-369

For citation: Muradov A.G., Drobot D.B., Grinshteyn Yu.I., Sakovich V.A., Andin A.V. Immediate results of complete conventional and bimammary bypass grafting in patients with multivessel coronary disease. Creative Cardiology. 2022; 16 (3): 355–69 (in Russ.). DOI: 10.24022/1997-3187-2022-16-3-355-369

Received / Accepted:  16.05.2022 / 15.09.2022

Keywords: coronary artery bypass grafting complete myocardial revascularization bimammary bypass grafting

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Abstract

Objective. Compare the immediate results of conventional and bimammary bypass grafting in patients with multivessel coronary disease.

Material and methods. From January 2018 to December 2021, 646 coronary artery bypass grafting operations were performed in the FCCS (Krasnoyarsk) in patients with coronary artery disease and multivessel coronary disease. Group 1 (n = 178) consisted of patients in whom both internal mammary arteries were used for complete myocardial revascularization, group 2 (n = 468), where the traditional revascularization technique was used. After propensity score matching, 178 patients were selected in each group. Male patients dominated both groups: 152 (85%) and 160 (90%) (p = 0.259), matched by age: 61.2 ±7.4 and 61.2 ± 7.2 (p = 0.768). In group 1, operations were performed both under conditions of cardiopulmonary bypass (1 on pump) and under conditions of a beating heart (1 off pump).

Results. In group 1, 99 (55.6%) patients underwent surgery under on pump conditions, 79 (44.4%) patients under off pump conditions, and in group 2, all operations were performed under on pump conditions (100%). In-hospital mortality was 3 (3%) in group 1 on pump and 3 (1.7%) in group 2 (p > 0.670). There was no statistical difference between group 2 and groups 1 on pump and 1 off pump in perioperative myocardial infarction (p > 0.999 and p > 0.999), number of bypassed arteries (p = 0.359 and p = 0.790), deep sternal wood infection complicated in 1 (1%) patient in the group 1 on pump (p = 0.357) and in 2 (2.5%) in the group 1 off pump (p = 0.094).

Conclusion. Bimammary bypass grafting is a modern effective method of myocardial revascularization both under cardiopulmonary bypass and under conditions of a beating heart, may be the operation of choice for the surgical treatment of patients with multivessel coronary artery disease.

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About Authors

  • Asim G. Muradov, Cardiovascular Surgeon; ORCID
  • Dmitriy B. Drobot, Dr. Med. Sci., Professor, Head of the Scientific and Methodological Department, Doctor-Methodologist; ORCID
  • Yuriy I. Grinshteyn, Dr. Med. Sci., Professor, Chief of Chair; ORCID
  • Valeriy A. Sakovich, Dr. Med. Sci., Professor, Chief of Chair and Clinic, Chief Physician; ORCID
  • Aleksey V. Andin, Cand. Med. Sci., Cardiovascular Surgeon, Head of Department; ORCID

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


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