Abstract
Introduction. Non ST elevation acute coronary syndrome (NSTEACS) patients often have multiple coronary artery disease, but they are older and have more comorbidities; they have a higher risk of surgical myocardial revascularization.
The aim of our study is to evaluate the efficacy and safety of emergency minimally invasive myocardial revascularization in patients with acute coronary syndrome without ST-segment elevation.
Material and methods. The prospective study included 297 patients with coronary heart disease operated at the Bakoulev National Medical Research Center for Cardiovascular Surgery for the period from 2003 to 2017. Depending on the severity of the patients condition, two groups were compared: 1st group – 145 patients with NSTEACS, 2nd group – 152 patients with chronic coronary heart disease. All patients underwent coronary artery bypass grafting on using the OPCAB technique.
Results. Conversion to cardiopulmonary bypass was observed in 7 (4.8%) patients in 1st group, in 2nd group it was 3 (2%) (p = 0.172). Postoperative complications did not differ in the groups as a whole (17.2% vs. 12.5% p = 0.250). Hospital mortality in 1st group was 1.4%, in 2nd group – 0% (p = 0,39). Other postoperative complications can be noted pneumonia was observed in 4 (2.6%) patients in 2nd group, where it was not observed in 1st group (p = 0.49). Acute heart failure in 1.4% of 1st group patients and 1.3% of 2nd group patients (p = 0.923). Transfusion of blood components was required in 1st group in 29 (20%) patients, 6 (3.9%) patients in 2nd group (p = 0.001). However, resternotomy for various reasons was performed in 4 (2.8%) patients in 1st group, 0% in the 2nd group (p = 0.039).
Conclusion. Off-pump coronary artery bypass grafting in patients with NSTEACS is accompanied with minimal operational risk, this is evidenced by the low frequency of postoperative complications.
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About the authors
- Alisher S. Beshimov, Postgraduate, ORCID
- Vadim Yu. Merzlyakov, Dr. Med. Sc., Head of Department, ORCID
- Ivan V. Klyuchnikov, Dr. Med. Sc., Professor, Senior Researcher, ORCID
- Anton I. Skopin, Cand. Med. Sc., Cardiovascular Surgeon, ORCID
- Alisher A. Melikulov, Dr. Med. Sc., Cardiovascular Surgeon, ORCID
- Madina V. Zhelikhazheva, Dr. Med. Sc., Senior Researcher, ORCID
- Sevindzh K. Mamedova, Cand. Med. Sc., Junior Researcher, ORCID
- Lyusine Zh. Enokyan, Cand. Med. Sc., Senior Researcher, ORCID
