The in Hospital Results of the Standard and on Beating Heart Left Ventricle Reconstructions in Complicated Cases of Coronary Heart Disease

Adham Dzhalilov, Leo Bockeria, Vadim Merzlyakov, Michael Alshibaya, Anton Skopin

A.N. Bakoulev Center for cardiovascular surgery Ministry of Health, Moscow, Russia

Date, time and location: 2018.05.25 13:30, Congress Hall, 2F–A

Abstract

BACKGROUND: Comparative analysis of the immediate results of standard and beating heart techniques for left ventricular (LV) reconstruction in combination with coronary artery bypass grafting in patients with complicated forms of coronary artery disease.

METHODS: 364 patients were operated on during the period from 2006 to 2016. To analyze the results three groups were formed: I group included 127 patients operated on the beating heart; group II comprised 93 patients operated by the classical method of the same surgeon; group III - 144 patients operated by the classical method of another surgeon.

To correct the aneurysm, geometric reconstruction of the LV on the Dore, which was almost always combined with coronary bypass surgery, was mainly used. At the same time in group I, the clamping cardiopulmonary bypass(CPB) was three times less, and averaged at 36 minutes.

RESULTS: In group I, the mortality rate was 0.8%, which was significantly different from the figures obtained in the operations of the classical technique. Also, the patients in this group spent less time in the hospital. Patients from the group spent the same time in the controlled mechanical ventilationand in the ICU. Patients had significantly less need for IABP and transfusion of blood components.

As a result of our work, we assume that the benefits of beating heart surgery include: reduction of the total time CPB, exclusion of cardioplegic arrest and clear visualization of the borders of viable myocardium.

CONCLUSIONS: The technique of reconstruction of LV on the beating heart in patients with postinfarction aneurysms minimizes the negative effects of cardiopulmonary bypass and cardioplegic arrest and primarily exclude myocardial ischemia.