Opcabg and oncabg myocardial revascularization in patients with left ventricular systolic dysfunction

Kharitonov N.V.

Federal Clinical Center of FMBA of Russia

Vitsukayev V.V.

Federal Clinical Center of FMBA of Russia

Makalskiy P.D.

Federal Clinical Center of FMBA of Russia

Trofimov N.A.

Republican Cardiology Dispensary

Zavgorodniy V.N.

Federal Clinical Center of FMBA of Russia

Yusupov A.I.

Federal Clinical Center of FMBA of Russia

Opcabg and oncabg myocardial revascularization in patients with left ventricular systolic dysfunction

Authors:

Kharitonov N.V., Vitsukayev V.V., Makalskiy P.D., Trofimov N.A., Zavgorodniy V.N., Yusupov A.I.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(2): 149‑154

DOI: 10.17116/kardio202114021149

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To cite this article:

Kharitonov NV, Vitsukayev VV, Makalskiy PD, Trofimov NA, Zavgorodniy VN, Yusupov AI. Opcabg and oncabg myocardial revascularization in patients with left ventricular systolic dysfunction. Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(2):149‑154. (In Russ.)
https://doi.org/10.17116/kardio202114021149

Подписка 2025-2 (Russian Journal of Cardiology and Cardiovascular Surgery)

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OBJECTIVE

To evaluate the immediate results of surgical treatment of coronary artery disease in patients with reduced left ventricular ejection fraction, to compare the outcomes and incidence of complications after off-pump and on-pump coronary artery bypass grafting.

MATERIAL AND METHODS

A retrospective study included 333 patients with reduced left ventricular ejection fraction who underwent coronary artery bypass surgery in 2008—2018. Patients were divided into 2 groups: 1 control group — on-pump coronary artery bypass grafting with warm-blood cardioplegia (ONCABG, n=153 patients), 2 study group — off-pump coronary artery bypass grafting (OPCABG, n=180 patients).

RESULTS

Duration of postoperative mechanical ventilation was significantly less in the study group (p=0.006). Both groups had an inflammatory response, but this process was significantly higher in the control group (p=0.004). In both groups, surgery improved myocardial contractility in early postoperative period by 17% (p=0.8). End-systolic and end-diastolic volumes were significantly reduced after surgery in both groups (p=0.4). Postoperative neurological morbidity was lower after OPCABG compared to ONCABG (p=0.036). In the study group, the incidence of postoperative cardiovascular and respiratory complications was significantly lower than in the control group (p=0.045). Need for re-sternotomy and renal replacement therapy was lower in the study group compared to the control group (p=0.023 and p=0.048, respectively). In-hospital mortality was significantly lower in the control group (p=0.004).

CONCLUSION

Off-pump CABG in patients with reduced left ventricular ejection fraction is an effective alternative to conventional on-pump surgery. Moreover. This procedure ensures less incidence of postoperative complications and mortality.

Keywords:

coronary artery bypass grafting

low ejection fraction

cardiopulmonary bypass

coronary artery disease

Authors:

Kharitonov N.V.

Federal Clinical Center of FMBA of Russia

Vitsukayev V.V.

Federal Clinical Center of FMBA of Russia

Makalskiy P.D.

Federal Clinical Center of FMBA of Russia

Trofimov N.A.

Republican Cardiology Dispensary

Zavgorodniy V.N.

Federal Clinical Center of FMBA of Russia

Yusupov A.I.

Federal Clinical Center of FMBA of Russia

Received:

20.08.2020

Accepted:

05.11.2020

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