Results of coronary bypass shutting in patients with acute ST-elevation myocardial infarction

Jalilov Adkham Kakhramonovich, Merzlyakov Vadim Yurievich, Klyuchnikov Ivan Vyacheslavovich, Salomov Makhmadsharif, Mammadova Sevinj

Introduction: The optimal coronary revascularization strategy remains by far the most discussed. Mini-invasive myocardial revascularization is considered as a potentially ideal strategy that avoids a large number of complications, completely eliminating cardiac arrest while achieving surgical goals in a qualitatively similar way. Objective: to study the immediate results of the surgical treatment of coronary heart disease using mini-invasive myocardial revascularization in patients with myocardial infarction with ST segment elevation. Materials and methods: The study included the experience of surgical treatment of 61 patients with acute myocardial infarction with ST segment elevation from 2003 to 2015, of which 28 - according to the ОРСАВ method and 33 - according to the standard CABG method with IR. The groups were comparable in age: the average age in the ОРСАВ group was 68.5 ± 7.3 years, and in the group of CABG with IR - 69.8 ± 7.7 years (p = 0.773). Results: In both groups, multiple shunting was most often performed: for example, in the MIRM group, shunting of three or more coronary arteries was performed in 26 (92.85%) patients, and in the CABG group with IC, in 30 (90.9%), significant there was no difference (p> 0.05). The total duration of operations was 5.6 ± 1.5 hours in ОРСАВ group and 5.33 ± 1.5 hours in the CABG group with IR and did not have a significant difference (p> 0.05). The total time spent in E.R. and the ICU in the first group (ОРСАВ) was 19.9 ± 2.5 hours in the second group (CABG IR) - 25.5 ± 2.6 hours, which also did not have a significant difference (p> 0.05 ) A significantly low number of complications (p <0.05) of the respiratory and renal in the postoperative period in patients undergoing minimally invasive myocardial revascularization is noted. In the general group of high-risk patients, both groups did not significantly differ in the frequency of deaths. So, in the MIRM group, the frequency of fatal cases was 7.14% (2 patients), and in the CABG group with IR - 6.06% (2 patients) (p> 0.05). Conclusions: minimally invasive myocardial revascularization is more effective in the surgical treatment of patients from the myocardial infarction group with ST segment elevation, which is confirmed by the data obtained during our study.

Keywords:coronary heart disease, surgical treatment, myocardial infarction with ST segment elevation, immediate results, minimally invasive myocardial revascularization, coronary bypass surgery, acute coronary syndrome.