OBJECTIVE

To analyze the immediate results of coronary bypass grafting without touching the aorta in patients with multiple-vessel coronary artery disease.

MATERIAL AND METHODS

A retrospective study included 707 patients (625 men and 82 women) with multiple-vessel coronary artery disease. The median age of patients was 61 (55—66) years; 105 (14.9%) had previous percutaneous intervention, 21.9% — diabetes mellitus. Inclusion criteria: patients aged ≥18 years, coronary bypass surgery without touching the aorta. Exclusion criteria: single-vessel lesion, cardiopulmonary bypass, redo surgeries, concomitant carotid artery surgery. Endpoints: in-hospital mortality and postoperative complications (stroke, sternal infection, perioperative myocardial infarction, acute kidney injury, exploration for bleeding).

RESULTS

Minimally invasive approach was used in 150 (21.2%) cases. Aortic calcification was observed in 195 (27.6%) patients. Bilateral IMA harvesting was performed in 394 (55.7%) cases, complete arterial revascularization — in 478 (67.6%) patients, sequential bypass surgery — in 257 (36.4%) cases. The number of distal anastomoses was 2 (2—3), surgery time — 160 (140—190) min. In postoperative period, myocardial infarction was not observed in any patient. The incidence of stroke was 0.8%, acute kidney injury — 1.3%, exploration for bleeding — 0.8%. In-hospital mortality was 0.8%.

CONCLUSION

“No touch aorta” CABG without any manipulations with aorta is effective for minimizing the risk of early strokes after CABG. Therefore, this procedure should be considered as a routine approach in patients with atherosclerotic aortic lesions.