Abstract
The article is devoted to peculiarities of the implementation of coronary artery bypass grafting on a beating heart patient coronary artery disease at high surgical risk with acute coronary syndrome without ST elevation, aneurysms of the coronary arteries on the background of multiple lesions of coronary arteries. As surgeons have improved their skills and experience over the past few decades, off-pump coronary bypass has evolved into a widely accepted procedure. Recently, off-pump coronary bypass has expanded its indications for high-risk patients with multiple comorbidities such as old age, kidney failure, lung disease, left ventricular dysfunction and childhood Kawasaki disease, and results are better than after bypass surgery with on-pump coronary bypass. However, the use of off-pump coronary bypass in patients with critical preoperative conditions remains important, as manipulation of the heart and displacement can lead to impaired hemodynamics and cardiac decompensation, especially myocardial perfusion deficiency occurs due to aneurysmic changes in the coronary arteries. Patients who develop serious perfusion deficits due to an aneurysm may require coronary artery bypass surgery, as percutaneous intervention usually fails due to the severity of the disease and significant narrowing of the arteries, putting the patient at a higher risk of a new aneurysm or perforation. This described approach allowed to avoid the expected complications. The patient had a smooth postoperative period.
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About the authors
- Vadim Yu. Merzlyakov, Dr. Med. Sc., Head of Department, orcid.org/0000-0001-5638-3723
- Alisher A. Melikulov, Dr. Med. Sc., Cardiovascular Surgeon, orcid.org/0000-0002-5164-9702
- Ivan V. Klyuchnikov, Dr. Med. Sc., Professor, Chief Researcher, orcid.org/0000-0002-8652-9639
- Alisher S. Beshimov, Postgraduate, orcid.org/0000-0002-4552-9368
- Madina F. Akhmedova, Cand. Med. Sc., Junior Researcher, orcid.org/0000-0002-5696-0807
- Mukhammadsharif A. Salomov, Cardiovascular Surgeon, orcid.org/0000-0002-3701-5818
- Sergey A. Donakanyan, Cand. Med. Sc., Head of Department, orcid.org/0000-0003-0942-2931
