Coronary artery bypass grafting of the left-sided thoracotomy in patients with coronary artery disease
Federal State Institution, Kaliningrad, Russian Federation.
OBJECTIVE: To present our experience coronary artery bypass surgery (CABG) from left thoracotomy
METHODS: From 09.2012 to 12.2015 at our center treated 226 patients with coronary artery disease who underwent CABG from left thoracotomy: 141 men (62.4%) and 85 women (37.6%). Age 68,6 ± 17,4 years; the number of diseased coronary arteries - 2.2. 19 patients had a history of CABG, in 7 cases using the left internal thoracic artery (LITA). Euroscore II 4,8 ± 3,7. Comorbidities- COPD, asthma, atherosclerosis, peripheral vascular disease, diabetes, obesity, CKD. Angina functional class- II-III, CHF - I-III of NYHA, EF 38 ± 13,8%. All patients underwent CABG anterior descending artery (LAD) Off pump: in 111 patients with isolated LAD lesion, the rest as a stage hybrid intervention. In 219 cases the LITA was used, in 7 carried autovenous subclavian artery bypass surgery (LITA used in the previous surgery)
RESULTS: All patients were discharged from hospital. The average time spent in the hospital 5,8 days. Mortality - 0. Angina functional class I - 12 patients, II - at 3, III - 2. The mean intraoperative blood loss - 150.0 ml. Bleeding in 2 patients (LITA bed). In 3 cases - urgent stenting OA in the early postoperative period due to acute ischemic changes. Two patients had thrombosis of the shunt. After surgery: AF episodes - in 6 patients; anginal attacks - in 3 -x; in 2 cases - the problem of wound healing
CONCLUSIONS: CABG from the left thoracotomy can be performed at one and multivessel disease - as a stage hybrid intervention
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