INCOMPLETE CORONARY REVASCULARIZATION AS AN INDEPENDENT RISK FACTOR OF OFF-PUMP CORONARY ARTERY BYPASS GRAFTING PROGNOSIS IN PATIENTS WITH ISCHEMIC HEART DISEASE

Currently, most researchers define the term complete coronary revascularization (CCR) as coronary arterial bypass graft (CABG) of at least one branch of each of the three affected coronary basins: left anterior descending artery (LAD) left circumflex artery (LCA) and right coronary artery RCA. The rejection of bypass of one or more diseased coronary basin is estimated as an incomplete coronary revascularization (ICR). Material and methods. This retrospective study included patients, underwent isolated coronary bypass operations from 2001 to 2014 in the Irkutsk Regional Hospital. 1418 patients underwent isolated off-pump bypass operations. ICR occurred in 469 patients, the CCR - in 949. All patients were divided into 2 groups: ICR group and CCR group. These groups were compared by the late survival and by the frequency of the major cardiac events (MACE). The results of study were assessed after 1, 5 and 10 years from the date of CABG. Results. Survival of patients of ICR group after 1,5,10 years after surgery was 98.5 %, 75.4 % and 75.4 % respectively, of CCR group of patients - 98.7 %, 88.7 % and 81.3 % (p = 0.006). In ICR group "free" from MACE after 1, 5 and 10 years after surgery were respectively 98.2 %, 70.8 % and 61.0 % of patients, while in CCR group those made 98.3 %, 84.6 % and 72,6 % (p = 0,007). We can conclude that incomplete revascularization can be defined as a prediction factor of worst long-term outcome results of CABG

Операция коронарного шунтирования на «работающем сердце» у больного ИБС с врожденной единой коронарной артерией

A single coronary artery is a congenital anomaly of the coronary arteries, in which the whole heart is supplied with a single coronary artery, which has one source of filling and leaves one orifice from one coronary sinus. Anomalies of coronary arteries are among the rare congenital heart defects. This defect is commonly detected in patients with coronary artery disease during selective coronary angiography. Single observations of coronary artery bypass grafting in patients with single coronary artery have been presented.Единая коронарная артерия - это врожденная аномалия коронарных артерий, при которой все сердце кровоснабжается коронарной артерией, имеющей один источник заполнения и отходящей одним устьем от одного коронарного синуса. Аномалии коронарных артерий относятся к редким врожденным порокам сердца. Нередко данный порок выявляется у больных ИБС при выполнении селективной коронарографии. Опубликованы единичные наблюдения операций коронарного шунтирования у больных с единой коронарной артерией. Представлено наблюдение успешной операции коронарного шунтирования на «работающем сердце» у больного 61 года с многососудистым атеросклеротическим поражением коронарных артерий и единой коронарной артерий типа RI