Minimally invasive myocardial revascularization in left coronary artery trunk pathology: safety, efficacy, and clinical results
Abstract
Aim. To assess safety and efficacy of minimally invasive myocardial revascularization (MIMR) in coronary heart disease (CHD) patients with left coronary artery (LCA) trunk pathology.
Material and methods. Forty-six CHD patients (41 males, 5 females) with LCA trunk pathology, who underwent offpump coronary aortic bypass graft (CABG) surgery, were examined. Mean age of the patients was 58.7±2.5 years, mean CHD duration – 53.9±11.3 months.
Results. Off-Pump Coronary Artery Bypass surgery is effective in CHD patients with LCA trunk pathology. It provides good results during in-hospital treatment, and is associated with low intra-operational risks.
Conclusion. CHD patients with LCA trunk pathology require special attention at all levels of treatment. MIMR is effective and safe in this category of patients. It gives an opportunity to decrease CABG traumatic effects and is prospective for both patients and surgeons.
About the Authors
M. V. ZhelikhazhevaRussian Federation
Kh. K. Mamaev
Russian Federation
V. Yu. Merzlyakov
Russian Federation
A. A. Zakharov
Russian Federation
References
1. Бокерия Л.А., Беришвили И.И., Сигаев И.Ю. Минимально инвазивная реваскуляризация миокарда. Москва 2001; 187-204.
2. Бокерия Л.А., Алекян Б.Г., Коломбо А., Бузиашвили Ю.И. Интервенционные методы лечения ишемической болезни сердца. Москва 2002; 181с.
3. Вищипанов С.А. Хирургическое лечение больных с поражением ствола левой коронарной артерии. Автореф дисс докт мед наук. Москва 1990.
4. Михеев А.А., Залесов В.Е., Пайвин А.А. и др. Оцека опыта 139 операций аортокоронарного шунтироования на работающем сердце без использования аппарата искусственного кровообращения. Груд и серд-сосуд хир 1997; 4: 12-4.
5. Сабистон Д. Развитие коронарной хирургии. История развития развития сердечно-сосудистой хирургии. Под ред. Л.А. Бокерия. Москва «Изд-во НЦ ССХ ими. А.Н. Бакулева РАМН» 1997; 87.
6. Ascione R, Narayan P, Rogers CA, et al. Early and midterm clinical outcome in patients with sever left ventricular dysfunction undergoing coronary artery surgery. Ann Thorac Surg 2003; 76: 793-9.
7. Ascione R, Caputo M, Calori G, et al. Predictors of atrial fibrillation after conventional and beating heart coronary surgery: a prospective, randomized study. Circulation 2000; 102 (13): 1530-5.
8. Bittner HB, Savitt MA. Off-pump coronary artery bypass grafting descreases morbidity and mortaliti in selected grop of high-risk patients. Ann Thorac Surg 2002; 74: 115-8.
9. Dacosta A, Tardy B, Favre JP, et al. Left main coronary artery disease. Arch Mal Coeur Vaiss 1994; 87(9): 1225-32.
10. Сhamberlain MH, Ascione R, Reeves BC, Angelini GD. Evaluation of the effectivenessof off-pump cjrjnary artery bypass grafting in high-risk patients: an observational studi. Ann Thjrac Surg 2002; 73: 1866-73.
11. Chauhan A, Ricei DR, Buller CE, et al. Clinical outcome in left main coronary artery PTCA and stenting. J Invas Cardiol 1996; 8(1): 41-9.
12. Kirklin JK, Westaby S, Blakstone EH, et al. Complement and the damaging effects of cardiopulmonary bypass. J Thorac Cardiovasc Surg 1983; 86: 845-57.
13. Laruelle CJ, Brueren JB. Stenting of “Unprotected” left main coronary artery stenosis: early and late results. JACC 1997; 37: 77-80.
14. Louagie YA, Gonzalez ME, Schroder E. Off-pump myocardial revascularizaition for left main stem disease in a high-risk patient. Acta Chir Belg 1999; 99(6): 309-11.
15. Meharval ZS, Mishra YK, Kohli V, et al. Off-pump multivessel coronary artery surgery in high-risk patients. Ann Thorac Surg 2002; 74: S1353-7.
16. Mishra M, Malhotra R, Mishra A, et al. Hemodinamic changes during displacement of the beating heart using epicardial stabilization for off-pump coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2002; 16: 685-90.
17. Yeatman M, Caputo M, Ascione R, et al. Off-pump coronary artery bypass surgery for clinical left main stem disease: safety, efficacy and outcome. Eur J Cardiothorac Surg 2001; 19: 239-44.
Review
For citations:
Zhelikhazheva M.V., Mamaev Kh.K., Merzlyakov V.Yu., Zakharov A.A. Minimally invasive myocardial revascularization in left coronary artery trunk pathology: safety, efficacy, and clinical results. Cardiovascular Therapy and Prevention. 2005;4(5):32-36. (In Russ.)