[Experience with the use of autoarterial conduits in coronary surgery]
F Sh Bakhritdinov1, Sh M Kamilov, A V Trynkin
1V. Vakhidov Scientific Center of Surgery, Tashkent, Republic of Uzbekistan.
Insights
Direct myocardial revascularization using arterial grafts improved heart function and reduced ischemia in patients with coronary artery disease (CAD). Most patients experienced symptom relief and were discharged in good condition.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Vascular Surgery
Context:
- 14 direct myocardial revascularization procedures for coronary artery disease (CAD) were performed between September 1999 and the present.
- Procedures utilized arterial conduits, primarily the internal mammary artery, with the right gastroepiploic artery used in two cases.
Purpose:
- To evaluate the efficacy of direct myocardial revascularization using arterial conduits in patients with coronary artery disease.
- To assess the impact of the surgical intervention on electrocardiogram (ECG) findings, ejection fraction (EF), and exercise tolerance.
Summary:
- Revascularization involved one, two, or three coronary arteries in 2, 8, and 4 patients, respectively.
- The majority of procedures (12 cases) were performed on a beating heart, with two cases utilizing cardiopulmonary bypass.
- Postoperative ECG showed resolution of ischemic changes, and average ejection fraction (EF) increased by 6-8%.
Impact:
- Improved myocardial contractility (EF) by 6-8% post-operation.
- Significant reduction in angina symptoms, with only 2 patients experiencing functional class II effort angina.
- All patients were discharged in satisfactory condition, with tailored medical management for residual symptoms.
Abstract:
Between September 1999 and until the present time 14 direct myocardial revascularization using arterial conduits were performed at the Department of Vascular Surgery and Surgical Treatment of CAD, V. Vakhidov Scientific Center of Surgery, RU Ministry of Public Health. The internal mammary artery was used in all the cases, right gastroomental artery in 2 cases. Revascularization of one coronary artery was accomplished in 2 patients, of two arteries in 8 and of three coronary arteries in 4 patients. In 12 cases, direct myocardial revascularization was realized on the working heart and in 2 cases, under cardiopulmonary bypass. Ischemic changes on the ECG at rest, recorded in the preoperative period, disappeared following operation. In all the patients, myocardial contractility (EF) after operation rose by 6-8% on an average as compared to the initial level. Physical exercise tolerance was measured by BEM in 6 (42.9%) patients. Angina of effort, FC II, was diagnosed only in 2 patients. All the patients were discharged in a satisfactory condition. Only patients with unstable angina were recommended to take long-acting nitrates whereas the remaining subjects were advised to take the antiaggregation doses of aspirin.
