Off-pump coronary artery bypass grafting in simultaneous surgical treatment of patients with concomitant atherosclerotic lesion of coronary and supra-aortic arteries

Zhbanov I.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0001-7321-6214

Kiladze I.Z.

Petrovsky National Scientific Center of Surgery

Maklagina A.V.

Petrovsky Russian Scientific Center of Surgery

Uryuzhnikov V.V.

Petrovsky Russian Research Center of Surgery

Shabalkin B.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-0409-4521

Off-pump coronary artery bypass grafting in simultaneous surgical treatment of patients with concomitant atherosclerotic lesion of coronary and supra-aortic arteries

Authors:

Zhbanov I.V., Kiladze I.Z., Maklagina A.V., Uryuzhnikov V.V., Shabalkin B.V.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2022;15(2): 114‑121

DOI: 10.17116/kardio202215021114

Downloaded: 16

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Zhbanov IV, Kiladze IZ, Maklagina AV, Uryuzhnikov VV, Shabalkin BV. Off-pump coronary artery bypass grafting in simultaneous surgical treatment of patients with concomitant atherosclerotic lesion of coronary and supra-aortic arteries. Russian Journal of Cardiology and Cardiovascular Surgery. 2022;15(2):114‑121. (In Russ.)
https://doi.org/10.17116/kardio202215021114

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

Close metadata

OBJECTIVE

To analyze the immediate postoperative results of off-pump coronary artery bypass grafting in simultaneous surgical treatment of patients with concomitant atherosclerotic lesion of coronary and supra-aortic arteries.

MATERIAL AND METHODS

A retro- and prospective analysis included 143 patients who underwent simultaneous coronary artery bypass grafting and carotid endarterectomy. All patients were divided into 2 groups depending on surgical procedure: 74 (51.7%) patients — off-pump coronary artery bypass grafting, 69 (48.3%) patients — on-pump coronary artery bypass grafting.

RESULTS

Off-pump coronary artery bypass surgery combined with carotid endarterectomy was characterized by less surgery time (243.3±50.3 and 280.5±63.9 min, p<0.05), blood loss (245.3±119.5 and 378.1±108.5 ml, p<0.05) and higher hemoglobin level at the end of surgery (11.1±1.1 and 10.1±1.3 g/l, p<0.05). Incidence of postoperative complications was low. There was no in-hospital mortality. There were no perioperative myocardial infarctions in both groups.

CONCLUSION

Simultaneous off-pump coronary artery bypass surgery and carotid endarterectomy can be safely performed with low incidence of perioperative complications and minimal in-hospital mortality.

Keywords:

carotid endarterectomy

coronary artery bypass surgery

off-pump coronary artery bypass surgery

coronary artery disease

Authors:

Zhbanov I.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0001-7321-6214

Kiladze I.Z.

Petrovsky National Scientific Center of Surgery

Maklagina A.V.

Petrovsky Russian Scientific Center of Surgery

Uryuzhnikov V.V.

Petrovsky Russian Research Center of Surgery

Shabalkin B.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-0409-4521

Received:

15.11.2021

Accepted:

10.12.2021

List of references:

Bokeria LA, Berishvili II, Sigaev IYu. Myocardial revascularization: available ways and approaches of development. Russian Journal of Thoracic and Cardiovascular Surgery. 1999;6:102-112. (In Russ.).
Belov YuV. Coronary bypass surgery via mini-thoracotomy on a working heart without artificial circulation. Russian Journal of Cardiology. 1998;38(8):12-17. (In Russ.).
Darvish NA, Ozolinsh AA, Eseneev MF, Mollaev EB, Valieva RR, Gvetadze IA, Israpilov MI. Treatment of patients with combined lesions of coronary and brachiocephalic arteries. Russian Journal of Angiology and Vascular Surgery. 2015;21(2):145-146. (In Russ.).
Zhbanov IV, Shabalkin BV. Repeated myocardial revascularization: the current state of the problem. Russian Journal of Thoracic and Cardiovascular Surgery. 2001;2:27-31. (In Russ.).
Belov YuV, Goryunov VS, Martynov AA. Surgical treatment of patients with atherosclerotic lesions of cardiac, cerebral and lower limb arteries. Russian Journal of Cardiology. 1992;11(12):103-104. (In Russ.).
Zhbanov IV, Sidorov RV, Kiladze IZ, Uryuzhnikov VV, Molochkov AV. Selection of optimal methods of coronary artery bypass surgery in high risk patients. Russian Journal of Cardiology and Cardiovascular Surgery. 2014;7(2):15-18. (In Russ.).
Buziashvili YuL, Ambatiello SG, Aleksakhina YuA, Pashchenkov MV. Influence of cardiopulmonary bypass on cognitive functions in patients with coronary artery disease. Korsakov Journal of Neurology and Psychiatry. 2005;1:150-157. (In Russ.).
Uryuzhnikov VV, Sidorov RV, Molochkov AV, Charnaya MA, Zhbanov IV, Shabalkin BV. On-pump beating heart coronary artery bypass grafting in patients with reduced left ventricular contractility. The Herald of the Pirogov National Medical and Surgical Center. 2010;5(4):25-28. (In Russ.).
Zhbanov IV, Martirosyan AK, Uryuzhnikov VV, et al. Safety and efficacy of coronary artery bypass grafting using both internal mammary arteries. Clinical and Experimental Surgery. Petrovsky Russian Journal. 2018;6(4):66-74. (In Russ.). https://doi.org/10.24022/1997-3187-2019-13-4-328-338
Kozlov BN, Shipulin VM, Vecherskiy YuYu, Akhmedov ShD, Kuznetsov MS. Efficacy of on-pump and off-pump coronary artery bypass grafting in low-risk patients. Russian Journal of Cardiology and Cardiovascular Surgery. 2009;3:19-24. (In Russ.).
Voznyuk IA, Arsenova NA, Khubulava GG. Cerebral complications of coronary artery bypass grafting. Cardiology. 2009;10:50-159. (In Russ.).
Chernov II, Enginoev ST, Kondratiev DA, et al. Long-term results of off-pump coronary artery bypass surgery. Clinical and Experimental Surgery. Petrovsky Russian Journal. 2020;8(4):49-54. (In Russ.). https://doi.org/10.33029/2308-1198-2020-8-4-49-54
Perez-Vela JL, et al. Neurologic complications in the immediate postoperative period after cardiac surgery. Role of brain magnetic resonance imaging. Rev Esp Cardiol. 2005;58(9):1014-1021. https://doi.org/10.1157/13078548
Bernhard VM, Johnson WD, Peterson JJ. Carotid artery stenosis. Association with surgery for coronary artery disease. Arch Surg. 1972;105(6):837-840. https://doi.org/10.1001/archsurg.1972.04180120018005
Nader ND, et al. Blood product use in cardiac revascularization: comparison of on- and off-pump techniques. Ann Thorac Surg. 1999;68:1640-1643. https://doi.org/10.1016/S0003-4975(99)00827-9
Kerendi F, et al. Impact of off-Pump coronary artery bypass graft surgery on postoperative pulmonary complications in patients with chronic lung disease. Ann Thorac Surg. 2011;91:8-15. https://doi.org/10.1016/j.athoracsur.2010.08.003
Jacobs A, et al. Alterations of neuropsychological function and cerebral glucose metabolism after cardiac surgery are not related only to intraoperative microembolic events. Stroke. 1998;29:660-667. https://doi.org/10.1161/01.STR.29.3.660
Hannan E, et al. Off-pump versus on-pump coronary artery bypass graft surgery: differences in short-term outcomes and in long-term mortality and need for subsequent revascularization. Circulation. 2007;116:1145-1152. https://doi.org/10.1161/CIRCULATIONAHA.106.675595
Sedrakyan A, et al. Off-pump surgery is associated with reduced occurrence of stroke and other morbidity as compared with traditional coronary artery bypass grafting: A meta-analysis of systematically reviewed trials. Stroke. 2006;37:2759-2769. https://doi.org/10.1161/01.STR.0000245081.52877
Izumi Y, Magishi K, Ishikawa N, Kimura F. On-pump beating-heart coronary artery bypass grafting for acute myocardial infarction. Ann Thorac Surg. 2006;81(2):573-576. https://doi.org/10.1016/j.athoracsur.2005.08.036

Close metadata