Abstract
This article presents some trends in the development of cardiovascular surgery in A.N. Bakoulev Scientific Center for Cardiovascular Surgery. During the period 2006–2014 the Center was carried out more than
20 thousand operations of coronary revascularization (CABG and PCI), with results comparable to leading cardiac centers of the world. In our center we actively put into practice hybrid operation in patients with multifocal
atherosclerosis: performing percutaneous coronary stenting of peripheral vessels combined with the traditional method of revascularization significantly reduce the number of postoperative complications in this group of patients. We have introduced into clinical practice the method of the geometrical reconstruction of the left ventricle in combination with coronary bypass and mitral valve annuloplasty and also the original method of geometrical reconstruction of the left ventricle with double patch in patients with post-infarction ventricular septal rupture. We have introduced into clinical practice postinfarction aneurysm resection technique on the beating heart. Analysis of the hospital the results showed the feasibility of this technique for performing surgery in high risk patients. Analysis of hospital and long-term results of CABG in diabetic patients with multivessel coronary artery disease showed that the presence of diabetes is accompanied by the risk of infection and some other hospital complications. The postoperative hyperglycemia more than 11 mmol\l is one of the causes of these complications. Our study showed a significant decrease of five-year survival and freedom from MACCE (death + myocardial infarction + stroke + repeated revascularization) in patients with diabetes after CABG compared with patients without diabetes. As part of the development
of alternative methods of myocardial revascularization in patients with end-stage coronary lesion we evaluated the effectiveness and safety of clinical use of transmyocardial laser revascularization combined with
intramyocardial introducing of autologous bone marrow stem cells. Since 2013 the Center is actively involved in research ISCHEMIA TRIAL (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches), dedicated to the comparative analysis of surgical and medical treatment of coronary artery disease. The Center is the focal point of ISCHEMIA TRIAL in Russia.
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About the authors
- Sigaev Igor' Yur'evich, MD, PhD, DSc, Professor, Chief of Department;
- Alshibaya Mikhail Mikhaylovich, MD, PhD, DSc, Professor, Chief of Department;
- Bockeria Ol'ga Leonidovna, MD, PhD, DSc, Professor, Chief Research Associate;
- Buziashvili Yuriy Iosifovich, Academician of RAS, Chief of Department;
- Golukhova Elena Zelikovna, MD, PhD, DSc, Professor, Corresponding Member of Russian Academy of Sciences, Chief of Department;
- Merzlyakov Vadim Yur'evich, MD, PhD, DSc, Chief of Department;
- Bockeria Leo Antonovich, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, Director of A.N. Bakoulev Scientific Center for Cardiovascular Surgery
