«ХИРУРГИЧЕСКАЯ ФОРМУЛА» КОРОНАРНОГО ШУНТИРОВАНИЯ: НОВЫЕ ВОЗМОЖНОСТИ ДЛЯ КОМПЬЮТЕРНОЙ ОБРАБОТКИ ДАННЫХ И ПЕРСОНАЛИЗИРОВАННОЙ ОЦЕНКИ РЕЗУЛЬТАТОВ ЛЕЧЕНИЯ

Abstract

The striving of cardiac surgeons for complete myocardial revascularization (MR) and the shortage of conduits resulted in the emergence of various options for sequential and composite coronary artery bypass grafting (CABG), which necessitates unifying specification of its various surgical options for each patient and developing an approach to systematize CABG options. Objective: To develop a “surgical formula” for CABG and evaluate the results of its application for the taxonomy of direct MR options. Methods: Four hundred fifty-two internal mammary artery-aortocoronary bypass (IMA-ACB) using two and three shunts (conduits) were performed from January 2020 to December 2023 at A.O. Makhachev Center for Cardiology and Cardiovascular Surgery, Makhachkala, Dagestan. Off-pump surgeries were performed in 315 patients, while 137 patients underwent on-pump CABG. The MR index was 3.5. Every IMA-ACB option had specifications indicating the particular donor artery, graft, and recipient coronary artery (CA). A “surgical formula” comprising the above specifications was developed for every MR surgery option. Results: There was no in-hospital mortality among the patients enrolled in the study. According to intraoperative monitoring, the incidence of shunt dysfunction was 0.4%. Overall, 32 “surgical formulas” were developed for all types of operations performed in patients enrolled in this study. Conclusion: Introducing “surgical formulas” in the operation records at the cardiac surgery departments facilitates the systematization and classification of CABG options. Keywords: Coronary artery disease, coronary artery bypass grafting, sequential coronary artery bypass grafting, conduit.