Abstract

Currently, most researchers define the term complete coronary revascularization (CCR) as coronary arterial bypass graft (CABG) of at least one branch of each of the three affected coronary basins: left anterior descending artery (LAD) left circumflex artery (LCA) and right coronary artery RCA. The rejection of bypass of one or more diseased coronary basin is estimated as an incomplete coronary revascularization (ICR). Material and methods. This retrospective study included patients, underwent isolated coronary bypass operations from 2001 to 2014 in the Irkutsk Regional Hospital. 1418 patients underwent isolated off-pump bypass operations. ICR occurred in 469 patients, the CCR - in 949. All patients were divided into 2 groups: ICR group and CCR group. These groups were compared by the late survival and by the frequency of the major cardiac events (MACE). The results of study were assessed after 1, 5 and 10 years from the date of CABG. Results. Survival of patients of ICR group after 1,5,10 years after surgery was 98.5 %, 75.4 % and 75.4 % respectively, of CCR group of patients - 98.7 %, 88.7 % and 81.3 % (p = 0.006). In ICR group "free" from MACE after 1, 5 and 10 years after surgery were respectively 98.2 %, 70.8 % and 61.0 % of patients, while in CCR group those made 98.3 %, 84.6 % and 72,6 % (p = 0,007). We can conclude that incomplete revascularization can be defined as a prediction factor of worst long-term outcome results of CABG.

Highlights

  • Минздрава России, Иркутск, Россия 2 ФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава России, Иркутск, Россия 3 ГБУЗ «Иркутская ордена «Знак почёта» областная клиническая больница», Иркутск, Россия

  • The rejection of bypass of one or more diseased coronary basin is estimated as an incomplete coronary revascularization (ICR)

  • ICR occurred in 469 patients, the coronary revascularization (CCR) – in 949

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Summary

БЕЗ ИСКУССТВЕННОГО КРОВООБРАЩЕНИЯ У БОЛЬНЫХ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА

Минздрава России, Иркутск, Россия 2 ФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава России, Иркутск, Россия 3 ГБУЗ «Иркутская ордена «Знак почёта» областная клиническая больница», Иркутск, Россия. В ходе сравнительной оценки отдалённые результаты операций с ПКР и НКР оценивались по количеству и времени наступления больших кардиальных событий и выживаемости. This retrospective study included patients, underwent isolated coronary bypass operations from 2001 to 2014 in the Irkutsk Regional Hospital. In ICR group “free” from MACE after 1, 5 and 10 years after surgery were respectively 98.2 %, 70.8 % and 61.0 % of patients, while in CCR group those made 98.3 %, 84.6 % and 72,6 % (p = 0,007). Неполная коронарная реваскуляризация (НКР) является общей проблемой хирургического лечения больных ишемической болезнью сердца (ИБС) при выполнении как чрескожных эндоваскулярных коронарных вмешательств (ЧЭКВ), так и операций коронарного шунтирования (КШ), независимо от использования искусственного кровообращения (ИК) либо выполнения операции на работающем сердце. В других исследованиях влияние НКР на отдалённые результаты операций не подтверждается

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