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ANGIOGRAPHIC EVALUATION OF GRAFT PATENCY AFTER MINIMALLY INVASIVE MULTIVESSEL CORONARY BYPASS SURGERY

https://doi.org/10.24884/0042-4625-2019-178-5-57-61

Abstract

The OBJECTIVE was to demonstrate perioperative outcomes and angiographic graft patency rates in the mediumterm period in patients after multivessel minimally invasive coronary artery bypass grafting (MICS CABG) procedures.

MATERIAL AND METHODS. In the period from 2014 to 2019, 270 patients with stable forms of coronary artery disease were operated on. All patients received left internal thoracic artery (LITA) and venous or arterial (radial artery) grafts. Off-pump surgery was performed in 264 cases (97.8 %). 127 patients underwent CT-bypass angiography (CT-BA) on a 128-slice computed tomography at least after 1 year after the operation. Mean follow-up duration was (30.3±7.9) months.

RESULTS. All patients received full myocardial revascularization. Mean number of grafts was (2.6±0.5). Perioperative mortality rate was 0.4 % (1 patient). Perioperative myocardial infarctions or cerebrovascular accident occurred in 3 (1.1 %) and 1 (0.4 %) patients. Overall graft patency rate in examined patients was 89.8 % (290 of 323). At the time of LITA, the patency of mammary grafts was 98.4 % (124 of 126), venous graft –84.0 % (163 of 194) and radial artery grafts – 100 % (3 of 3).

CONCLUSION. MICS CABG was safe and effective and was characterized by minimal rate of perioperative complications. This procedure allowed to achieve complete revascularization of the myocardium without sternotomy and could be performed off-pump (in most cases). MICS CABG provide excellent long-term graft patency rates.

The authors declare no conflict of interest.

The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

About the Authors

M. A. Snegirev
http://www.minicardiacsurgery.ru
Saint-Petersburg City Hospital № 40 of Kurortny District
Russian Federation
Mikhail A. Snegirev - Cardiac surgeon


A. A. Paivin
http://www.minicardiacsurgery.ru
Saint-Petersburg City Hospital № 40 of Kurortny District
Russian Federation
Artem A. Paivin - Chief cardiac surgeon


D. O. Denisiuk
http://www.minicardiacsurgery.ru
Saint-Petersburg City Hospital № 40 of Kurortny District
Russian Federation
Dmitrii O. Denisyuk - Cardiac suergeon


O. A. Drozdova
Saint-Petersburg City Hospital № 40 of Kurortny District
Russian Federation
Olga A. Drozdova - CT/MRI


G. M. Mitusova
Saint-Petersburg City Hospital № 40 of Kurortny District
Russian Federation
Galina M. Mitusova - Chief CT/MRI


L. B. Sichinava
Saint-Petersburg City Hospital № 40 of Kurortny District
Russian Federation
Lana B. Sichinava - Cardiologist


N. E. Khvan
Saint-Petersburg City Hospital № 40 of Kurortny District
Russian Federation
Nikolai E. Khvan - Cardiac surgeon


References

1. Farkouh M. E., Domanski M., Sleeper L. A. et al. Strategies for multivessel revascularization in patients with diabetes. N Engl J Med. 2012;367(25):2375‒2384.

2. Lamy A., Devereaux P. J., Prabhakaran D. et al. Five-Year Outcomes after Off-Pump or On-Pump Coronary-Artery Bypass Grafting. N Engl J Med. 2016;375(24):2359‒2368.

3. Taggart D. P., Benedetto U., Gerry S. et al. Bilateral versus Single InternalThoracic-Artery Grafts at 10 Years. N Engl J Med. 2019;380(5):437-446.

4. Meginn J. T., Shariff M. A., Nahagiez J. P. et al. Minimally invasive CARG is safe anal reproductible: report of the first thousand cases. In: International society for minimally invasive cardiothoracic surgery (ISMICS) Annal Meeting. Boston, USA, 2014, P. c5

5. Ziankou A., Ostrovsky Y. Multi-vessel small thoracotomy coronary artery bypass using in situ bilateral internal thoracic arteries and right gastroepiploic artery. Multimed Man Cardiothorac Surg. 2017. Apr. 27.

6. Ziankou A. A. Early and late results of no-touch aorta multivessel minimally invasive coronary artery bypass grafting: a propensity score-matched study. Clin Experiment Surg Petrovsky J. 2018;1(19):10–20. (In Russ.).

7. Yurchenko D. L., Payvin A. A., Denisyuk D. O. et al. Multivessel minimally invasive coronary artery bypass. Grudnaya i Serdechno-Sosudistaya Khirurgiya. 2015;57(6):40–46. (In Russ.).

8. Une D., Sakaguchi T. Initiation and modification of minimally invasive coronary artery bypass grafting. Gen Thorac Cardiovasc Surg. 2019;67(4):349– 354. Doi: 10.1007/s11748-018-1050-7 10.1007/s11748-018-1050-7.

9. Kikuchi K., Mori M. Less-invasive coronary artery bypass grafting international landscape and progress. Curr Opin Cardiol. 2017;32(6):715–721.

10. Ruel M., Shariff M. A., Lapierre H. et al. Results of the Minimally Invasive Coronary Artery Bypass Grafting Angiographic Patency Study. J Thorac Cardiovasc Surg. 2013;147(1):203‒208.

11. Gaudino M., Antoniades C., Benedetto U. et al. Mechanisms, Consequences, and Prevention of Coronary Graft Failure. Circulation. 2017;136(18):1749–1764.

12. Guo M. H., Wells G. A., Glineur D. et al. Minimally Invasive coronary surgery compared to STernotomy coronary artery bypass grafting: The MIST trial. Contemp Clin Trials. 2019;78:140–145.


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For citations:


Snegirev M.A., Paivin A.A., Denisiuk D.O., Drozdova O.A., Mitusova G.M., Sichinava L.B., Khvan N.E. ANGIOGRAPHIC EVALUATION OF GRAFT PATENCY AFTER MINIMALLY INVASIVE MULTIVESSEL CORONARY BYPASS SURGERY. Grekov's Bulletin of Surgery. 2019;178(5):57-61. (In Russ.) https://doi.org/10.24884/0042-4625-2019-178-5-57-61

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ISSN 0042-4625 (Print)
ISSN 2686-7370 (Online)