Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Advantages of cardiopulmonary bypass without cardioplegia and left thoracotomy in geometric reconstruction with coronary artery bypass grafting

Authors: Merzlyakov V.Yu., Skopin A.I., Baychurin R.K., Krivenkova E.M., Kaabak A.M.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2024-21-2-156-162

UDC: 616.124.2-089.86

Link: Clinical Physiology of Blood Circulaiton. 2024; 21 (2): 156-162

Quote as: Merzlyakov V.Yu., Skopin A.I., Baychurin R.K., Krivenkova E.M, Kaabak A.M. Advantages of cardiopulmonary bypass without cardioplegia and left thoracotomy in geometric reconstruction with coronary artery bypass grafting. Clinical Physiology of Circulation. 2024; 21 (2): 156–162 (in Russ.). DOI: 10.24022/1814-6910-2024-21-2-156-162

Received / Accepted:  10.04.2024 / 07.05.2024

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Abstract

Coronary artery bypass grafting through left thoracotomy is a relatively new technique aimed at improving the immediate results of surgical treatment of coronary artery disease. This technique avoids complications associated with sternotomy, has a good cosmetic effect, and shortens the hospital period and rehabilitation period. The technique of left ventricular reconstruction in patients with postinfarction aneurysm, performed on a beating heart without cardioplegia, reduces the negative effect of cardiopulmonary bypass. Peripheral connection of cardiopulmonary bypass allows reducing the number of cannulas in the surgical field and performing operation from minimal access. We present a case of successful reconstruction of a postinfarction left ventricular aneurysm with coronary artery bypass grafting in conditions of normothermic cardiopulmonary bypass without cardioplegia through a left thoracotomy.

References

  1. Горбачева Н.С., Веселовская Н.Г., Николаева М.Г., Чумакова Г.А., Момот А.П., Рудакова Д.М. Новые факторы риска острого инфаркта миокарда у мужчин молодого возраста. Кардиология: новости, мнения, обучение. 2022; 10 (3): 42–49. DOI: 10.33029/2309- 1908-2022-10-3-42-49
  2. Мерзляков В.Ю., Скопин А.И., Мамедова С.К., Гатамова Н.А. Хирургическое лечение пациента с осложненной формой ишемической болезни. Сердечно-сосудистые заболевания. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2014; 15 (1): 62–65.
  3. Алшибая М.М., Вищипанов С.А. Оценка отдаленных результатов хирургического лечения постинфарктной аневризмы левого желудочка у больных ИБС молодого возраста. В кн.: Материалы докладов XV Всероссийского съезда сердечно-сосудистых хирургов. Сердечно-сосудистые заболевания. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2009; 10 (6): 78.
  4. Carson P., Wertheimer J., Miller A., O’Connor C.M., Pina I.L., Selzman C. et al. The STICH trial (Surgical Treatment for Ischemic Heart Failure): mode-of-death results. JACC Heart Fail. 2013; 1 (5): 400–408. DOI: 10.1016/j.jchf.2013.04.012
  5. Ярбеков Р.Р., Жалилов А.К., Мурадов М.М., Омонов С.Х., Шарипов И.М., Исматов А.А. и др. Реконструктивная техника хирургического лечения постинфарктных аневризм левого желудочка у пациентов с осложненными формами ишемической болезни сердца. Евразийский кардиологический журнал. 2019; S1: 360–361.
  6. Молочков А.В., Алексеев И.А., Мурылев В.В., Бугримова М.А., Аракелян К.А., Рымарчук Р.А. и др. Реконструкция левого желудочка на работающем сердце при гигантской аневризме у больного с низкими резервами миокарда. Хирургия. Журнал им. Н.И. Пирогова. 2017; 9: 85–87. DOI: 10.17116/hirurgia2017985-87
  7. Бокерия Л.А., Мерзляков В.Ю., Скопин А.И., Ключников И.В., Мамедова С.К. Непосредственные результаты реконструкции левого желудочка на сокращающемся сердце. Грудная и сердечно-сосудистая хирургия. 2011; 4: 36–38 (in Russ.).
  8. Guan Z., Guan X., Gu K., Lin X., Lin J., Zhou W. et al. Short-term outcomes of on- vs off-pump coronary artery bypass grafting in patients with left ventricular dysfunction: a systematic review and meta-analysis. J. Cardiothorac. Surg. 2020; 15 (1): 84. DOI: 10.1186/s13019-020- 01115-0
  9. Мерзляков В.Ю., Скопин А.И., Меликулов А.А., Байчурин Р.К., Иванов И.В. Хирургическое лечение постинфарктной аневризмы левого желудочка в условиях параллельной перфузии у молодого пациента. Сердечно-сосудистые заболевания. Бюллетень НЦССХ
  10. Yu Y., Gu C.X., Wei H., Liu R., Chen C.C., Fang Y. Repair of left ventricular aneurysm during off-pump coronary artery bypass surgery. Chin. Med. J. (Engl.). 2005; 118 (13): 1072–1075.
  11. Wei H., Chai S., Liu C., Huang X., Gu C. Left ventricular aneurysm repair: Off-pump linear plication versus on-pump patch plasty. Braz. J. Cardiovasc. Surg. 2019; 34 (2): 187–193. DOI: 10.21470/1678-9741-2018-0366
  12. Miller C.L., Zwischenberger B.A. Minimally invasive surgical coronary artery bypass in women. Ann. Cardiothorac. Surg. 2023; 12 (6): 596–605. DOI: 10.21037/acs-2023-adw-15
  13. Byrne J.G., Aklog L., Adams D.H., Cohn L.H., Aranki S.F. Reoperative CABG using left thoracotomy: a tailored strategy. Ann. Thorac. Surg. 2001; 71 (1): 196–200. DOI: 10.1016/s0003-4975(00)02182-2
  14. Zenati M.A., Bhatt D.L., Bakaeen F.G., Stock E.M., Biswas K., Gaziano J.M. et al. Randomized trial of endoscopic or open vein-graft harvesting for coronary-artery bypass. N. Engl. J. Med. 2019; 380 (2): 132–141. DOI: 10.1056/NEJMoa1812390
  15. Кривенкова Е.М., Мерзляков В.Ю., Скопин А.И., Мамедова С.К. Современное состояние проблемы шунтирования передней межжелудочковой ветви левой коронарной артерии с применением левой внутренней грудной артерии. Грудная и сердечно- сосудистая хирургия. 2023; 65 (1): 16–23. DOI: 10.24022/0236-2791-2023-65-1-16-23
****
  1. Gorbacheva N.S., Veselovskaya N.G., Nikolaeva M.G., Chumakova G.A., Momot A.P., Rudakova D.M. New risk factors for acute myocardial infarction in young men. Cardiology: News, Opinions, Training. 2022; 10 (3): 42–49 (in Russ.). DOI: 10.33029/2309-1908-2022-10-3-42-49
  2. Merzlyakov V.Yu., Skopin A.I., Mamedova S.K., Gatamova N.A. Surgical treatment of a patient with a complicated form of ischemic disease. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2014; 15 (1): 62–65 (in Russ.).
  3. Alshibaya M.M., Vishipanov S.A. Evaluation of long-term results of surgical treatment of postinfarction left ventricular aneurysm in young patients with coronary heart disease. In: Materials of reports of the XV All-Russian Congress of Cardiovascular Surgeons. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2009; 10 (6): 78 (in Russ.).
  4. Carson P., Wertheimer J., Miller A., O’Connor C.M., Pina I.L., Selzman C. et al. The STICH trial (Surgical Treatment for Ischemic Heart Failure): mode-of-death results. JACC Heart Fail. 2013; 1 (5): 400–408. DOI: 10.1016/j.jchf.2013.04.012
  5. Yarbekov R.R., Zhalilov A.K., Muradov M.M., Omonov S.H., Sharipov I.M., Ismatov A.A. et al. Reconstructive technique of surgical treatment of postinfarction left ventricular aneurysms in patients with complicated forms of coronary heart disease. Eurasian Journal of Cardiology. 2019; S1: 360–361 (in Russ.).
  6. Molochkov A.V., Alekseev I.A., Murylev V.V., Bugrimova M.A., Arakelyan K.A., Rymarchuk R.A. et al. Off-pump left ventricular reconstruction for giant aneurysm in patient with low myocardial capacity. Pirogov Russian Journal of Surgery. 2017; 9: 85-87 (in Russ.). DOI: 10.17116/hirurgia2017985-87
  7. Bockeria L.A., Merzlyakov V.Yu., Skopin A.I., Klyuchnikov I.V., Mamedova S.K. Immediate results of left ventricular reconstruction on a contracting heart. Grudnaya i Serdechno-Sosudistaya Khirurgiya. 2011; 4: 36–38 (in Russ.).
  8. Guan Z., Guan X., Gu K., Lin X., Lin J., Zhou W. et al. Short-term outcomes of on- vs off-pump coronary artery bypass grafting in patients with left ventricular dysfunction: a systematic review and meta-analysis. J. Cardiothorac. Surg. 2020; 15 (1): 84. DOI: 10.1186/s13019-020- 01115-0
  9. Merzlyakov V.Yu., Skopin A.I., Melikulov A.A., Baychurin R.K., Ivanov I.V. Surgical treatment of postinfarction left ventricular aneurysm under parallel perfusion in a young patient. Serdechno-sosudistye zabolevaniya. Byulleten' NTSSSKh
  10. Yu Y., Gu C.X., Wei H., Liu R., Chen C.C., Fang Y. Repair of left ventricular aneurysm during off-pump coronary artery bypass surgery. Chin. Med. J. (Engl.). 2005; 118 (13): 1072–1075.
  11. Wei H., Chai S., Liu C., Huang X., Gu C. Left ventricular aneurysm repair: Off-pump linear plication versus on-pump patch plasty. Braz. J. Cardiovasc. Surg. 2019; 34 (2): 187–193. DOI: 10.21470/1678-9741-2018-0366
  12. Miller C.L., Zwischenberger B.A. Minimally invasive surgical coronary artery bypass in women. Ann. Cardiothorac. Surg. 2023; 12 (6): 596–605. DOI: 10.21037/acs-2023-adw-15
  13. Byrne J.G., Aklog L., Adams D.H., Cohn L.H., Aranki S.F. Reoperative CABG using left thoracotomy: a tailored strategy. Ann. Thorac. Surg. 2001; 71 (1): 196–200. DOI: 10.1016/s0003-4975(00)02182-2
  14. Zenati M.A., Bhatt D.L., Bakaeen F.G., Stock E.M., Biswas K., Gaziano J.M. et al. Randomized trial of endoscopic or open vein-graft harvesting for coronary-artery bypass. N. Engl. J. Med. 2019; 380 (2): 132–141. DOI: 10.1056/NEJMoa1812390
  15. Krivenkova E.M., Merzlyakov V.Yu., Skopin A.I., Mamedova S.K. The current state of the problem of bypass surgery of the left anterior descending artery using the left internal thoracic artery. Grudnaya i Serdechno-Sosudistaya Khirurgiya. 2023; 65 (1): 16–23 (in Russ.). DOI: 10.24022/0236-2791-2023-65-1-16-23

About Authors

  • Anton I. Skopin, Cand. Med. Sci., Cardiac Surgeon; ORCID
  • Renat K. Baychurin, Cardiac Surgeon; ORCID
  • Elena M. Krivenkova, Postgraduate, Cardiac Surgeon; ORCID
  • Aleksey M. Kaabak, Cardiac Surgeon; ORCID

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