Short and long-term results of using bilateralinternal mammary artery in elderly patients

Authors: Galimov N.M., Martirosyan A.K., Zhbanov I.V., Uryuzhnikov V.V., Kiladze I.Z., Revishvili G.A., Shabalkin B.V., Perevertov V.A., Aleksandrova E.N.

Company: Petrovsky Russian Research Center of Surgery, Abrikosovskiy pereulok, 2, Moscow, 119991, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2019-13-4-328-338

For citation: Galimov N.M., Martirosyan A.K., Zhbanov I.V., Uryuzhnikov V.V., Kiladze I.Z., Revishvili G.A., Shabalkin B.V., Perevertov V.A., Aleksandrova E.N. Short and long-term results of using bilateral internal mammary artery in elderly patients. Creative Cardiology. 2019; 13 (4): 328–38 (in Russ.). DOI: 10.24022/1997-3187-2019-13- 4-328-338

Received / Accepted:  02.12.2019/15.12.2019

Keywords: old age bilateral internal mammary artery immediate and long-term results

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Abstract

Objective. To study the short and long-term results of the coronary artery bypass grafting using two internal thoracic arteries in elderly patients and to determine the prospects of this operation in this age group.

Material and methods. A retro- and prospective analysis of the results of surgical treatment of 205 patients older than 70 years, who underwent isolated coronary artery bypass grafting, was carried out. Two groups were formed: in group 1 – two internal mammary arteries were used, and in group 2 – one internal mammary artery. When analyzing the results of the postoperative period (mean follow-up time 66±26 months), the duration of the patient's stay in cardiac intensive care and in hospital, survival after surgery, freedom from cardiac events (myocardial infarction, recurrence of angina, fatal rhythm disorders, repeated myocardial revascularization) were studied.

Results. We noted a significant increase in surgery time in the group where both internal mammary arteries were used for myocardial revascularization (259.7±53.8 minutes vs. 235.4±45.3 minutes, p=0.001). The duration of stay in the cardiac intensive care unit and the frequency of perioperative complications did not differ significantly between the groups (p>0.05). The cumulative survival analysis also revealed no statistically significant differences after coronary bypass surgery using two and one internal thoracic artery over a 7-year follow-up period (p=0.112). But the freedom from cardiac complications was significantly higher in the group where both internal thoracic arteries were used (82.9% vs. 68.2%, p=0.016).

Conclusion. The short-term postoperative results of coronary bypass surgery using two internal thoracic arteries in elderly patients do not differ from those of traditional coronary bypass surgery with one internal thoracic artery. Bimammary coronary bypass surgery in patients of this age group is not associated with an increase in the frequency of perioperative complications and with sufficient experience can be performed at a high level of safety.

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About Authors

  • Nariman M. Galimov, Postgraduate; ORCID
  • Armen K. Martirosyan, Cardiovascular Surgeon; ORCID
  • Igor' V. Zhbanov, Dr. Med. Sc., Professor, Head of Department; ORCID
  • Vadim V. Uryuzhnikov, Cand. Med. Sc., Senior Researcher; ORCID
  • Irakli Z. Kiladze, Cand. Med. Sc., Senior Researcher; ORCID
  • Georgiy A. Revishvili, Postgraduate; ORCID
  • Boris V. Shabalkin, Dr. Med. Sc., Professor; ORCID
  • Vadim A. Perevertov, Cand. Med. Sc., Cardiologist; ORCID
  • Elena N. Aleksandrova, Cardiologist; ORCID

Chief Editor

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