This journal is
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Year 2012 Vol. 20 No 5
GENERAL AND SPECIAL SURGERY
A.A. ZIANKOU1,2, YU. P. OSTROVSKIJ3,4
IMMEDIATE RESULTS OF THE FULL MINIMALLY INVASIVE MYOCARDIUM REVASCULARIZATION
ME “Vitebsk Regional Clinical Hospital” 1,
EE “Vitebsk State Medical University” 2,
SE RSPC “CardiologY” 3,
SEE “Belarusian Medical Academy of Postgraduate Education” 4,
THE Republic of Belarus
Objectives. To estimate immediate results of the proposed strategy of the full minimally invasive myocardium revascularization (MIMR) at the multiple lesions of the coronary arteries.
Methods. From 2011 up to 2012 at the cardiac surgery department of ME “Vi-tebsk regional clinical hospital” 71 patients with the ischemic heart disease underwent full MIMR at the multiple lesions of coronary arteries. The proposed strategy of the MIMR was directed to avoid artificial cardiopulmonary bypass and manipulations on the ascending aorta, usage of the left minithoracotomy access and tendency to perform functionally adequate arterial revascularization of the left ventricle. Revascularization index composed 2,5. 68 patients underwent composite-sequential grafting without involving aorta; 3 patients – coronary artery bypass grafting. Full arterial revascularization was performed in 49 (69,0%) cases, in 7 (9,9%) cases – hybrid MIMR with a complete arterial revascularization of the left ventricle. In 2 (2,8%) patients the pump-assisted beating heart approach was employed during the part of the main operation stage.
Results. There were no lethal outcomes in the researched group of patients. Immediate results of the MIMR showed a low rate of the perioperative complications (bleeding, arrhythmia and infection) and they are associated with short period of ICU – stay and reduced hospital length of stay.
The development of complications during the early postoperative period hasn’t been established to depend reliably on the patient’s age, number of the affected and grafted coronary arteries, the ejection fraction of the left ventricle, the presence of the affection of the left coronary artery trunk, multifocal atherosclerosis, diabetes mellitus, heart failure and arrhythmia.
Conclusions. The worked out method of the MIMR allows achieving complete myocardial revascularization, improving early postoperative period; it is associated with a small number of complications and is effective and safe in high-risk patients.
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210037, Respublika Belarus, g. Vitebsk, ul. Voinov-internatsionalistov, d. 37, UZ «Vitebskaya oblastnaya klinicheskaya bolnitsa», otdelenie kardiokhirurgii,
Zenkov Aleksandr Aleksandrovich
Ziankou A.A. Candidate of Medical Sciences, Head of Cardiac Surgery Chair of ME ”Vitebsk Regional Clinical Hospital”, Associate Professor of the Surgery Chair of the Faculty of Advanced Training and Staff Retraining of EE “Vitebsk State Medical University”.
Ostrovskij YU. P. Corresponding member of National Academy of Sciences, Doctor of Medical Sciences, Professor, Head of Laboratory of Cardiac Surgery of SE RSPC “Cardiology”, Head of Cardiac Surgery Chair of SEE “Belarusian Medical Academy of Postgraduate Education."