СЛОЖНАЯ ХИРУРГИЧЕСКАЯ ТЕХНИКА ПРИ ОПЕРАЦИЯХ АОРТОКОРОНАРНОГО ШУНТИРОВАНИЯ НА РАБОТАЮЩЕМ СЕРДЦЕ

Introduction. The change in the typical «profile» of the patient in recent decades (older patients, patients with a large number of concomitant pathologies, repeated revascularization, lack of sufficient conduits due to the presence of peripheral arterial and/or venous pathology) forces surgeons to change (adapt) the surgical technique in the direction of greater use of sequential and composite grafts for myocardial revascularization. Material and methods. In the Department of Cardiac Surgery of the Republican Specialized Scientific and Practical Medical Center of Cardiology, during the period 2015–2018 yy, 500 off-pump CABG procedures were performed. Patients were divided into 2 groups depending on the usage of sequential and composite grafting techniques: I group – 110 (22,0 % %) patients with the usage of such techniques and II group – 390 (78,0 %) patients with standard surgical techniques. Results. The average duration of the operation was about 261 minutes in group I and 221 minutes in group II. In both groups, the left internal thoracic artery was used in all patients. The average number of distal anastomoses per patient was 3.7 and 3.0, respectively, in Groups I and II. There were no statistically significant differences between the groups by the level of complications and mortality. Conclusions. The use of the technique of sequential and composite grafting for off-pump myocardial revascularization is safe and effective from the point of view of immediate results of operations. Further accumulation of clinical material is required to study the long-term results of these operations.