[Early and long-term outcomes of bilateral inthernal thoracic artery grafting for coronary artery bypass surgery]. / Blizhaishie i otdalennye rezul'taty bimammarnogo koronarnogo shuntirovaniia.

OBJECTIVE: To evaluate safety of coronary artery bypass surgery using bilateral internal mammary artery and effectiveness of this procedure in long-term postoperative period. MATERIAL AND METHODS: The study involved 129 patients who underwent CABG for the period 2006-2007. There were 2 groups of patients depending on surgical strategy: group 1 (n=61) - double IMA harvesting, group 2 (n=68) - CABG using single IMA. Short-term results were compared using standard statistical methods. Long-term survival was compared using Kaplan-Meyer method. RESULTS: Revascularization index was 3.014±0.76 in the 1st group and 3.1±0.73 in the 2nd group (p>0.05). In-hospital mortality was 0% and 1.47%, respectively (p> 0.05). A 10-year survival was 95.1% and 91.2%, respectively (p>0.05). Freedom from cardiac events (mortality, myocardial infarction, recurrent angina pectoris) was significantly different (95% vs. 81%, p<0.05). CONCLUSION: Significantly lower rate of adverse cardiac events in long-term postoperative period in comparison with conventional CABG clearly demonstrates high quality of life after coronary artery bypass surgery using bilateral internal mammary artery for a long time. Therefore, this procedure is preferred in patients with coronary artery disease.

[Features of surgical treatment of advanced age patients with coronary artery disease]. / Osobennosti khirurgicheskogo lecheniia bol'nykh ishemicheskoi bolezn'iu serdtsa pozhilogo i starcheskogo vozrasta.

OBJECTIVE: To optimize surgical treatment of patients aged over 70 years with coronary artery disease. MATERIAL AND METHODS: There were 398 patients aged over 70 years with coronary artery disease for the period 2006-2017. All patients were divided into 3 groups: group 1 - on-pump coronary artery bypass grafting (CABG) with cardiac arrest; group 2 - on-pump beating heart CABG, group 3 - off-pump CABG. RESULTS: On-pump beating heart CABG in patients over 70 years old is followed by reduced incidence of perioperative complications including acute heart failure, acute respiratory failure, neurological complications, reduced length of ICU- and hospital-stay compared with on-pump CABG and cardiac arrest. However, off-pump CABG is optimal in advanced age patients because this approach reduces duration of surgery, intraoperative blood loss, incidence of acute heart failure, neurological complications and cardiac rhythm disturbances. Postoperative annual and 5-year survival rates were 98.1 and 84.2%, respectively. CONCLUSION: Off-pump CABG is preferable in advanced age patients. Surgical treatment of these patients is characterized by high clinical efficacy in long-term period after surgery.

[B.V. Petrovsky and development of home coronary surgery]. / B.V. Petrovskii i razvitie otechestvennoi koronarnoi khirurgii.

Academician B.V. Petrovsky had considerable impact on coronary surgery development in our country. Current Russian coronary surgery comparable with world standards is based on scientific and practical initiatives initiated and developed by B.V. Petrovsky and his students.