Background The method of coronary-coronary bypass grafting was described in 1987 but has not been widely used, and there are only a few studies that report good short-term and mid-term results as well as some individual cases of long-term follow-up. In our medical institution, we carried out an analysis of the long-term results of coronary-coronary bypass grafting, which are presented in this study. Methods This was a retrospective single-center study on 95 patients who underwent coronary-coronary bypass grafting as a supplement to the standard coronary bypass grafting procedure. All patients underwent angiographic assessment of the coronary bypass grafts during the long-term follow-up period. The observation period was up to 123 months. Angiographic assessment of 109 coronary-coronary grafts was carried out. Results Twelve (7.6%) arterial and 11 (19.3%) venous conduits were found to be occluded, and 8 (10.3%) arterial and 10 (31.3%) venous coronary-coronary grafts were occluded during the observation period. Conclusion Arterial coronary-coronary artery bypass grafting represents an alternative technique that allows complete myocardial revascularization.
Surgery for ASDs, VSDs and TOFs can be carried out with minimal early mortality in both countries. The discrepancy in early postoperative morbidity illustrates the challenges in comparative studies between different countries, cultures and health care systems. The establishment of a decentralized surgical facility has increased the access to cardiac surgery to the population in Archangels region.
Оbjective. This study determines the factors that can affect the value of the parameters of intraoperative flowmetry of coronary bypass grafts.
Material and methods. TTFM is a routine procedure accompanying coronary artery bypass grafting at the Federal State Budgetary Institution FTSSSh (Penza). This retrospective study included 995 consecutive patients who underwent isolated coronary artery bypass grafting of the left coronary artery. The exclusion criteria were damage to the right coronary artery bed, the emergency nature of the operation, and the combined pathology of the valvular apparatus. Patients who underwent anastomosis revision due to flowmetry parameters changes were also excluded from the study. Intraoperative assessment of coronary artery bypass grafts was performed using VeryQ and MiraQ MediStim flowmeters (Norway).
Results. A total of 1733 arterial and 479 venous grafts were evaluated. The following factors influenced the average volumetric blood flow velocity value: composite shunting of the border stenosis increases the chance of reducing the volumetric blood flow below the threshold value by 1.841 times (OR=1.841; p=0.018), the combination of occlusion and borderline stenosis with composite shunting increases the chance of reducing the volumetric blood flow velocity by 3.91 times (OR=3.91; p=0.041), an increase in the diameter of the bypassed artery by 1.0 mm reduces the chance of a decrease in blood flow volume velocity by 53.7% (OR=0.423; p=0.05).
Conclusion. The following factors influence the peripheral resistance index: coronary artery diameter (OR=0.21; p=0.001), degree of artery proximal stenosis (OR=0.987; p=0.034), the vascular wall condition (OR=2.25; p=0.05), type of conduit used (OR=0.298; p=0.002), and shunting method (OR=1.699; p=0.017). The following factors influence the mean volumetric blood flow velocity value: bypass method (OR=1.841; p=0.018), a combination of occlusion and borderline stenosis in composite bypass grafting (OR=3.91; p=0.041), and the bypassed artery diameter (OR=0.423; p=0.423; p=0.05).
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