The closest results of coronary shunting operation on working heart with artificial blood circulation

Abstract

Purpose: the comparative analysis of efficiency of operations of coronary shunting on working heart with artificial blood circulation. Material and methods: The analysis of results of 2254 operations of coronary shunting of the patients who were on treatment in the federal center it is warm - vascular surgery of Astrakhan since April 2009 till June 2011. Statistical data processing was made by means of the Microsoft Exel program. Results and discussion: Coronary shunting with artificial blood circulation without a cardioplegia (CP) was executed at 874 patients (men - 648 (74 %); women - 226 (26 %)). Middle age of the patients was 56,8 years. We identified an acute myocardial infarction in the anamnesis of 638 patients. The emission fraction was less then 35 % in 122 patients. Stenocardia of the III-IV functional class was found in 716 patients. An acute coronary syndrome was met in 25 patients. Average duration of operation was 171 minutes with a time of artificial blood circulation of 73 minutes. Expenses of blood components were 45,6 ml per operation. Medium duration of hospitalisation after operation was 8,6 days. The hospital lethality was 7. Complications: acute perturbations of brain blood circulation-4, acute myocardial infarction-13, bleeding-7, instability of a breast-18, infection of the sternum -7. Cause of death: acute perturbations of brain blood circulation -6, acute myocardial infarction-1. Conclusion: Coronary shunting with artificial blood circulation without a cardioplegia is rather safe method of treatment of coronary heart disease. Unloading of heart reduces need in oxygen of the myocardium that allows applying various ways of drainage of the anastomosis zone, and also doesn’t limit the surgeon on time at the main stage in favor of improvement of quality of work. This technology can be used by the surgeon with “average” manually skills. Use of artificial blood circulation at observance of the appropriate preventive measures (intraoperation ultrasonic research of an aorta) isn’t reflected in number of embol complications. This technique can be recommended for application for daily practice as for treatment of patients with stable forms of coronary heart disease, and at an acute coronary syndrome.