Abstract
Background. The most common operation to treat patients with coronary artery disease is coronary artery bypass
grafting (CABG). Gold standard in revascularization left anterior descending artery is application left internal mammary
artery. Many retrospective article documented better long-term survival and results when compared bilateral
internal mammary artery (BIMA) to a single internal mammary artery (SIMA). Despite encouraging results, many
surgeons are reluctant to employment BIMA in CABG.
The aim of study was evaluate effectiveness and safety application BIMA in the surgical treatment of coronary artery
disease.
Materials and methods. Recruitment of patients in the study was retrospective by “continuous observation”. Primary
endpoint was mortality, parameters such as: myocardial infarction, stroke and stenting of coronary artery – defined
as secondary endpoints. Between October 2012 to December 2017, in Federal Center of High Medical Technologies
was examined and underwent CABG in 2692 patients. CABG with BIMA was performed in 1765 (65.5%) cases.
Mean age patients in BIMA group was 65.9±14.2 years. In the study prevailed men 60.8%.
Results. Hospital mortality in SIMA group was 1.2% (11 patients), BIMA group – 0.5% (9 patients) (p=0.052).
Procedure-related complications as: postoperative bleeding, wound infection and stroke between groups statistically
no difference. Mean follow-up period for SIMA group was 38.1 months (95% confidence interval (CI) 37.7–38.4),
BIMA – 38.7 months (95% CI 38.5–38.8). Survival estimate by Kaplan–Meier method showed survival in SIMA
group for 18 months 98.4% (95% CI 97.3–99.1), 36 months – 93.3% (95% CI 88.7–96.1); in BIMA group for
18 months – 99.4% (95% CI 99.0–99.7), 36 months – 98.2% (95% CI 96.6–99.0). Log-rank test: p<0.01.
Conclusion. Application of BIMA in CABG is safe and effective procedure who improved the mid and long-term
results of surgical treat of coronary artery disease.
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About the authors
- Yuriy A. Shneyder, Dr. Med. Sc., Professor, Chief Doctor; orcid.org/0000-0002-5572-3076
-
Viktor G. Tsoy, Deputy Chief Doctor by Surgery, Head of Cardiac Surgery Department № 1; orcid.org/0000-0003-0338-4399
-
Aleksandr A. Pavlov, Cardiovascular Surgeon; orcid.org/0000-0001-6088-5486
-
Pavel A. Shilenko, Сardiovascular Surgeon; orcid.org/0000-0003-4357-9203
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Mikhail S. Fomenko, Cand. Med. Sc., Сardiovascular Surgeon; orcid.org/0000-0002-5272-8381
