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4 . 2020

Long-term results of the off-pump coronary artery bypass

Abstract

Aim - to study the long-term results of the Off-pump Coronary Artery Bypass (OPCAB).

Material and methods. A retro-prospective analysis of the results of OPCAB, was carried out in 404 patients who were operated on in our Center in 2011 years. The median age of patients was 58 (53-64) years. There were 357 men (88.4%). A history of arterial hypertension was recorded in 183 (45.3%) patients, atrial fibrillation (AF) in 92 (22.8%), diabetes mellitus in 70 (17.3%) and stroke in 15 (3.7%), NYHA FC III-IV chronic heart failure in 129 (31.9%), angina pectoralis III-IV FC was detected in 281 (69.6%) patients, left main coronary artery lesion was found in 143 (35.4%), 3-vessel disease in 338 (83.9%), the median ejection fraction (EF) of the left ventricle (LV) was 56 (50-60)%, the median of systolic pressure in the pulmonary artery was - 24 (23-26) mm Hg. The median follow-up was 98 (72-103) months.

Results. The median revascularization index is set to 3 (2-4). As conduits, the left internal thoracic artery was used in 383 (95%) patients, the right internal thoracic artery in 7 (1.7%), the radial artery in 154 (38%) and the saphenous vein grafts in 323 (80%). Perioperative myocardial infarction (MI) occurred in 10 (2.5%) patients. Stroke occurred in 4 (1%) patients, all strokes were ischemic. A reoperation for bleeding was performed in 7 (1.7%) patients; postoperative AF occurred in 39 (9.7%); deep sternal infection occurred in 3 (0.7%) patients; median time of the intensive care unit stay was 24 (19-27) hours, the median of the hospital stay was 11 (9-13) days, the 30-day mortality rate is 1.2% (5 patients). Long-term survival was 81%.

Conclusion. OPCAB is an effective technique with a long-term survival of 81%. The most influential risk factors for long-term survival after OPCAB: age, AF in history, LVEF, 3-vessel disease, perioperative MI.

Keywords:off-pump coronary artery bypass, coronary artery bypass grafting, coronary heart disease

Funding. The study had no sponsor support.
Conflict of interests. The authors declare no conflict of interests.
Contribution. Conception and design – Chernov I.I., Enginoev S.T., Kondrat’ev D.A., Ziankou A.A.; data analysis and interpretation – Ekimov S.S., Motreva A.P., Magomedov G.M., Tsaroev B.S.; statistic analysis – Enginoev S.T.; manuscript writing – Chernov I.I., Enginoev S.T., Kondrat’ev D.A., Ziankou A.A.; final approval of manuscript – Chernov I.I., Tarasod D.G., Komarov R.N.
For citation: Chernov I.I., Enginoev S.T., Kondrat’ev D.A., Ziankou A.A., Ekimov S.S., Motreva A.P., Magomedov G.M., Tsaroev B.S., Tarasov D.G., Komarov R.N. Long-term results of the off-pump coronary artery bypass. Clinical and Experimental Surgery. Petrovsky Journal. 2020; 8 (4): 49–54. DOI: https://doi.org/10.33029/2308-1198-2020-8-4-49-54 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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