Abstract
In 2021, the Department of Surgical Treatment of Coronary Heart Disease and Minimally Invasive Coronary Surgery carried out scientific work on several topics, including a comprehensive theme of optimizing the surgical correction of complicated forms of coronary artery disease, as postinfarction left ventricle (LV) aneurysms on the beating heart primarily. The introduction of new technological methods for performing myocardial revascularization operations continued, in particular, in addition to performing operations for cardiac aneurysms in conditions of parallel perfusion and beating heart, this is the expansion of the use of sequential and composite grafting in operations on a beating heart, performing operations on a beating heart in patients with left coronary artery trunk stenosis, the use of mini-accesses, the MICS preparation and optimization, the active use of endoscopic harvesting of the great saphenous vein, the introduction of endoscopic harvesting of the mammary artery into practice. Work continued on the use of beating heart surgery in patients with ACS. The research optimizing the use of left internal mammary artery, depending on the severity of the lesion of the bypass artery has begun. In 2021, the number of treated patients increased by 10% (736 in total) compared to 2019. During the reporting period, the department performed 98 operations “on-pump”, of which 76 (77.5%) were isolated coronary bypass grafting under conditions of parallel perfusion, 5 (5%) of-pump coronary artery bypass surgery were converted to on-pump. In 9 (9.1%) cases, parallel perfusion was associated with resection of the LV aneurysm, and in 3 (3%) cases – with the correction of valvular pathology. The overall revascularization index was 3.0. In 2021, 158 minimally invasive off-pump surgeries were performed with a mortality rate of 1.2%. The most frequent number of distal anastomoses was 3 and 4. The main task of the department is to expand the range of surgical interventions, with the priority introduction of minimally invasive technologies, which provide the availability of direct myocardial revascularization with minimal risk of mortality and complications, primarily to patients at high surgical risk, with severe concomitant somatic pathology, the elderly, with multifocal atherosclerosis, with acute coronary syndrome.
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About the authors
- Vadim Yu. Merzlyakov, Dr. Med. Sci., Head of the Department; 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, Cardiovascular Surgeon; ORCID
- Aleksey M. Kaabak, Cardiovascular Surgeon; ORCID
- Elena M. Krivenkova, Postgraduate; ORCID
