Year 2014 Vol. 22 No 1




EE Vitebsk Regional Clinical Hospital 1,
EE Vitebsk State Medical University 2,
SE RSPC Cardiology 3,
SEE Belarusian Medical Academy of Post-Graduate Education4,
The Republic of Belarus

Objectives. To carry out the comparative analysis of the immediate results of the minimally invasive myocardial revascularization (MIMR) and conventional coronary artery bypass surgery (CABS) on the beating heart and with artificial circulation (AC) for optimization of the surgical treatment of the patients with coronary artery disease (CAD).
Methods. During the period from 2008-2013 yrs. 183 patients with the CAD underwent MIMR (1st group), 156 patients CABS via sternotomy (2nd group) and 99 patients CABS with AC via sternotomy (3d group) in the cardiac surgery department of ME Vitebsk regional clinical hospital. In the 1st group the MIMR strategy was directed to avoid the artificial circulation with cardioplegia and manipulations on the ascending aorta, application of the left minithoracotomic access and tendency to perform complete or functionally adequate composite-sequential arterial myocardial revascularization.
Results. MIMR with aortic no-touch technique was accompanied by the lower index of revascularization (2,33) in comparison with traditional AC on the beating heart (2,79) and with AC (3,17), more frequent application of arterial bypass (80,9%, 54,5% 43,4%), reducing the frequency of complete (62,8%, 87,8% 89,9%) and increasing the incidence of functionally adequate revascularization (37,2%, 12,2% 10,1%) of myocardial revascularization (<0,05). Immediate results were found to be satisfactory (absence of the major cardiovascular complications) in 98,9% of patients (MIMR group), in 96,8% of patients (CABS group on BH) and 95,0% of patients (CABS group with AC) and they were quite comparable (>0,05).
Conclusions. Application of the MIMR leads to the reduction of the perioperative complications rate (intra- and postoperative blood loss, wound infection) and also to the decrease the length of postoperative hospital stay saving the effectiveness of the coronary procedures. Further comparative randomized trials of minimally invasive coronary surgery results are considered to be necessary with respect to survival, quality of life, the frequency of adverse events, patency of the shunts.

Keywords: minimally invasive myocardial revascularization, minimally invasive coronary surgery, complete revascularization, functionally adequate revascularization
p. 33 43 of the original issue
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Address for correspondence:
210037, Respublika Belarus', g. Vitebsk, ul. Voinov-internatsionalistov, d. 37, UZ Vitebskaia oblastnaia klinicheskaia bol'nitsa, otdelenie kardiokhirurgii,
Ziankou Alexander Alexandrovich
Information about the authors:
Ziankou A.A. PhD, a head of the cardiac surgery department of ME Vitebsk Regional Clinical Hospital, an associate professor of the surgery chair of Faculty of Advanced Training and Staff Retraining of EE Vitebsk State Medical University.
Ostrovskij U.P. Corresponding member of National Academy of Sciences, MD, professor, a head of laboratory of cardiac surgery of SE RSPC Cardiology, a head of cardiac surgery chair of SEE Belarusian Medical Academy of Postgraduate Education.
Vuhristenko K.S. An assistant of the hospital surgery chair of EE Vitebsk State Medical University.
Lojko N.G. A cardiologist of the cardiac surgery chair of EE Vitebsk State Medical University.
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