Muradov M.MRepublican Specialized Scientific and Practical Medical Center of Cardiac Surgery, Russian Federation
Title: Minimal invasive myocardial revascularization by techniques MICSCAB in patients with multiple coronary artery lesion.
Introduction: The coronary artery bypass grafting (CABG) on the beating heart, without cardiopulmonary bypass, firmly took its place in the arsenal of advanced cardiac surgery centers. With the development of minimally invasive interventions, it became apparent that the rehabilitation process in these patients was shorter, which was economically beneficial. To date, there are devices for safely performing classic CABG from mini-access.
Materials and methods: Since autumn 2018 - on 01.2020 in the department of cardiac surgery of the Republican Specialized Scientific and Practical Medical Center of Cardiac Surgery we have performed 1400 CABG. 2 groups of patients were selected for comparison. I- (743) patients who performed the MICSCAB procedure, II (657) the OPCAB procedure. Patients had 2x (n = 56) and 3x (n = 1344) coronary artery lesions. Access to the heart is a thoracotomy in the left 5th intercostal space and sternotomy. In I -group skin incision 10-12cm. In II -group all patients were given the first formed of LIMA-LAD anastomosis, and then formed anastomosis on right coronary artery and circumflex artery. The time of CABG from mini-access (150 ± 28 min.), OPCAB (180 ± 36 min.)
Results: In postoperative period there were no cases of postoperative pneumonia, severe respiratory failure. There were no significant differences between the groups in the postoperative period. The revascularization index was in the I-group (2,6 ± 1.8), II (3, 2 ± 0.7 (p > 0.05)). Patient was in ICU is 1 day. The length of hospitalization after surgery is significantly less in group - I (4,3 ± 1.2d), vs group - II (6,4 ± 1.7d (p < 0.05)). After CABG, all patients of I-group noted less pain, improvement of condition and quality of life. Functional and laboratory indicators improved against the background of the operation. Earlier complaints about heart pain, shortness of breath, feeling of air shortage, weakness decreased.
Conclusion: Thus, multiple coronary artery bypass by minimally invasive technique (MICSCAB) is a modern and safe approach in treating patients with coronary artery disease. Mini-access reduces surgery injuries, improves the early postoperative period, reduces the frequency of complications, and is cost-effective. Considering of fact, that the high efficiency and safety of MICSCAB for patients with coronary artery disease with high surgical risk, it is necessary to further developing mini-invasive operations in cardiac surgical practice in the Republic of Uzbekistan.
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