Abstract
Researches in the department are focused on several main directions at this moment. One of the most relevant topics is the development and practice implementation the methodology of surgical treatment of post-infarction left ventricular aneurysms on beating heart with parallel perfusion in combination with off-pump myocardial revascularization and evaluation of the results as well. Initially this method shows good hospital results with minimal complications and mortality compared to standard surgery in conditions of cardiopulmonary bypass and cardioplegia. Another research is related to the evaluation of the efficiency and safety of minimally invasive myocardial revascularization in patients with left main coronary stenosis and concomitant multiple coronary lesions. Research is also directed on implementation the methods of endoscopic graft harvesting for coronary bypass grafting from the great saphenous vein and arterial conduits from the radial and mammary arteries. The department actively conducts Researches related to using CABG surgery on a beating heart in patients with comorbidities. Study evaluating the features of use off-pump surgery in patients with ischemic heart disease and comorbidities is currently underway. Preliminary results evaluation indicates the effectiveness of using this method of myocardial revascularization, and the long-term prognosis of these patients is mainly determined by oncological pathology. The conclusion is preliminary and further researches in this direction are required.
References
- Behnes M., Schupp T., Mashayekhi K., Akin I. 'Offpump' left ventricular reconstruction – a causal and less invasive surgical option for patients with advanced systolic heart failure? Eur. J. Heart Fail. 2020; 22 (4): 581–3. DOI: 10.1002/ejhf.1737
- Yan J., Jiang S.L. Impact of surgical ventricular restoration on early and long-term outcomes of patients with left ventricular aneurysm: a single-center experience. Medicine (Baltimore). 2018; 97 (41): e12773. DOI: 10.1097/MD.0000000000012773
- Tarasov D.G., Chernov I.I., Molochkov A.V., Pavlov A.V. Experience of plasty of postinfarction left ventricular aneurysms performed on a beating heart. Kazanskij medicinskij zhurnal. 2019; 100 (3): 500–4 (in Russ.). DOI: 10.17816/KMJ2019-500
- Merzlyakov V.Yu., Skopin A.I., Mamedova S.K., Klyuchnikov I.V., Melikulov A.A., Dzhalilov A.K. Myocardial revascularization and left ventricular cavity reconstruction in a beating heart in a patient with ischemic cardiomyopathy. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2019; 20 (7–8): 621–6 (in Russ.). DOI: 10.24022/1810-0694-2019-20-7-8-621-626
- Apostolidou E., Kalisetti D., Logani S., McCormick D.J., Goldberg S. Myocardial revascularization in patients with left main coronary disease. J. Invasive Cardiol. 2013; 25 (4): 201–7.
- Neumann F.-J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U. 2018 ESC/EACTS guidelines on myocardial revascularization. European Heart Journal. 2019; 40 (2): 87–165. DOI: 10.1093/eurheartj/ehy394
- Bajaj N.S., Patel N., Kalra R., Marogil P., Bhardwaj A., Arora G. et al. Percutaneous coronary intervention vs. coronary artery bypass grafting for left main revascularization: an updated meta-analysis. Eur. Heart J. Qual. Care Clin. Outcom. 2017; 3 (3): 173–82. DOI: 10.1093/ehjqcco/qcx008
- Mohr F.W., Morice M.-C., Kappetein A.P., Feldman T.E., Ståhle E., Colombo A. et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. The Lancet. 2013; 381 (9867): 629–38. DOI: 10.1016/s0140-6736(13)60141-5
- Khan A.R., Golwala H., Tripathi A., Riaz H., Kumar A., Flaherty M.P. et al. Meta-analysis of percutaneous coronary intervention versus coronary artery bypass grafting in left main coronary artery disease. Am. J. Cardiol. 2017; 119 (12): 1949–56. DOI: 10.1016/j.amjcard.2017.03.022
- Makikallio T., Holm N.R., Lindsay M., Spence M.S., Erglis A., Menown I.B.A. et al. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. The Lancet. 2016; 10061 (388): 2743–52. DOI: 10.1016/S0140-6736(16)32052-9
- Holm N.R., Mä kikallio T., Lindsay M.M., Spence M.S., Erglis A., Menown I.B. et al. A percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of unprotected left main stenosis: updated 5- year outcomes from the randomised, non-inferiority NOBLE trial. The Lancet. 2020; 395 (10219): 191–9. DOI: 10.1016/s0140-6736(19)32972-1
- Eagle K.A., Guyton R.A., Davidoff R., Ewy G.A., Fonger J., Gardner T.J. et al. ACC/AHA guidelines for coronary artery bypass graft surgery: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to revise the 1991 guidelines for coronary artery bypass graft surgery). Circulation. 1999; 100 (13): 1464–80. DOI: 10.1161/01.cir.100.13.1464
- Windecker S., Kolh P., Alfonso F., Collet J.P., Cremer J., Falk V. et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for CardioThoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur. Heart J. 2014; 35 (37): 2541–619. DOI: 10.1093/eurheartj/ehu278
- Patel M.R., Calhoon J.H., Dehmer G.J., Grantham J.A., Maddox T.M., Maron D.J. et al. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for coronary revascularization in patients with stable ischemic heart disease. Journal of Nuclear Cardiology. 2017; 24 (5): 1759–92. DOI: 10.1007/s12350-018-1292-x
- Murzi M., Cаputо M., Аrеsu G., Duggаn S., Micеli А., Glаubеr M. et al. On-pump and off-pump coronary artery bypass grafting in patients with left main stem disease: a propensity score analysis. J. Thоrаc. Cаrdiоvаsc. Surg. 2012; 143 (6): 1382–8. DOI: 10.1016/j.jtcvs.2011.07.035
- Rogers C.A., Pike K., Campbell H., Reeves B.C., Angelini G.D., Gray A. et al. Coronary artery bypass grafting in high-risk patients randomized to off- or onPump Surgery: a randomized controlled trial (the CRISP trial). Health Technol. Assess. 2014; 18 (44): 1–157. DOI: 10.3310/hta18440
- Cavallaro P., Itagaki S., Seigerman M., Chikwe J. Operative mortality and stroke after on-pump vs offpump surgery in high-risk patients: an analysis of 83,914 coronary bypass operations. Eur. J. Cardiothorac. Surg. 2013; 45 (1): 159–64. DOI: 10.1093/ejcts/ezt221
- Bockeria L.A., Aslanidi I.P., Shavman M.G., Shurupova I.V., Trifonova T.A., Ekaeva I. et al. Informative value of quantitative indicators of myocardial blood flow and coronary reserve according to positron emission tomography with 13N-ammonium combined with computed tomography in assessing the functional significance of coronary artery stenosis. Creative Cardiology. 2019; 13 (1): 17–27 (in Russ.). DOI: 10.24022/1997-3187-2019-13-1-17-27
- Bockeria L.A., Aslanidi I.P., Shurupova I.V., Shavman M.G., Derevyanko E.P., Ekaeva I.V. et al. Quantitative non-invasive assessment of myocardial blood flow and coronary reserve by dynamic stress-PET/CT scan with 13N-ammonium in the diagnosis of the functional significance of coronary artery stenosis. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2017; 18 (5): 489–500 (in Russ.). DOI: 10.24022/1810-0694-2017-18-5-489-500
- Zenati M.A., Bhatt D.L., Bakaeen F.G., Stock E.M., Biswas K., Gaziano J.M. et al. REGROUP Trial Investigators. Randomized Trial of Endoscopic or Open VeinGraft Harvesting for Coronary-Artery Bypass. N. Engl. J. Med. 2019; 380 (2): 132–41. DOI: 10.1056/NEJMoa1812390
- Lucchese G., Jarral O.A. Endoscopic vein harvest: benefits beyond (a) reasonable doubt? J. Thorac. Dis. 2019; 11 (Suppl. 9): S1342–S1345. DOI: 10.21037/jtd.2019.04.06
About the authors
- Vadim Yu. Merzlyakov, Dr. Med. Sci., Head of Department of Surgical Treatment of IHD and Minimally Invasive Coronary Surgery; ORCID
- Ivan V. Klyuchnikov, Dr. Med. Sci., Professor, Senior Researcher; ORCID
- Anton I. Skopin, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
- Madina V. Zhelihazheva, Dr. Med. Sci., Senior Researcher; ORCID
- Sevindzh K. Mamedova, Cand. Med. Sci., Junior Researcher; ORCID
- Renat K. Baychurin, Cardiovascular Surgeon; ORCID
- Ruslan A. Khaziev, Postgraduate, Cardiovascular Surgeon; ORCID
- Aleksey M. Kaabak, Postgraduate; ORCID
- Elena M. Krivenkova, Postgraduate; ORCID
