РЕЗ УЛЬТАТЫ ОПЕР АЦИЙ АКШ НА РАБОТАЮЩЕМ СЕРДЦЕ В ЗАВИСИМОСТИ ОТ ТИПА ПОРАЖЕНИЯ КОРОНАРНОГО РУСЛАЮЩЕМ

Introduction. The stem lesion of the left coronary artery is considered to be one of the risk factors influencing the results of coronary artery bypass grafting surgery. In particular, this applies to the conduct of such operations in the conditions of artificial blood circulation and cardioplegy. Very little is known about the impact of the presence of the lesion of the trunk of the left coronary artery on the results of off-pump coronary artery bypass surgery. Material and methods. In the Department of Cardiac Surgery of RSSPMC of Cardiology for the period of April 2015 – April 2018, were performed 500 off-pump CABG procedures (this amounted to 96,9 % of the total number of 516 patients who undergone isolated CABG operations). All patients, depending on the presence or absence of the lesion location were divided into 2 groups: I Group-222 (44,4 %) patients with the location of lesion in the mainstem of LCA or in proximal parts of LAD or Cx and II Group-278 (55б6 %) patients with more distal lesions. The risk of surgical intervention by EuroScore calculator was greater in patients of I group-4,32 points (4,63 %), while in the II group it amounted to 3,43 (3,83 %) points (p = 0,06). Results. The average duration of the operation was about 228 minutes in group I and 232 minutes in group II. The average number of distal anastomomoses in both groups was more than three anastommoses per patient (3,2 and 3,1 respectively). Hospital mortality amounted to 1,3 % in group I and 1,0 % for the second group. Conclusions. The presence of a very proximal lesions (left mainstem, proximal LAD and Cx) of the left coronary artery is not an additional risk factor, complicating the implementation of off-pump CABG in this group of patients. Such operations are a safe method and can be performed without damage to the completeness of revascularization with the same low mortality as in patients without left mainstem lesions.