Khirurgiia · 2020
[Features of surgical treatment of advanced age patients with coronary artery disease].
СтатьяНазвание и аннотация: Оригинал на русском
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Uryuzhnikov V V, Zhbanov I V, Galimov N M, Kiladze I Z, Martirosyan A K, Revishvili G A, Shabalkin B V
Аннотация
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.
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.