Short-term Results of On-pump Coronary Artery Bypass and Off-pump Bypass Surgery at Simultaneous Interventions on Coronary and Brachiocephalic Arteries

Material and methods. The study included 309 patients, divided into two groups. In group 1, 169 patients underwent simultaneous intervention with off pump coronary artery bypass and carotid endarterectomy. Accordingly, 140 patients in group 2 underwent conventional coronary artery bypass graft and carotid endarterectomy. For all clinical parameters, the patients of both groups were statistically comparable and did not differ significantly.

Results. Therefore, the total duration of the operation was 6.22±1.5 h in the first off pump coronary bypass group , 5.9±1.3 h in the second group conventional CABG, and did not differ significantly (p=0.072). The frequency of cerebrovascular complications in both groups did not have a statistically significant difference. Hospital mortality in the I group was 4.7% (8 cases), and in the second group – 9.3% (13 cases) (p=0.1235). In the off pump coronary bypass group, single-stage intervention revealed a statistically significant benefit in terms of the frequency of the need for hemodialysis, the need for prolonged ventilation, as well as for a set of complications in the form of a primary endpoint (death + myocardial + stroke + hemodialysis +redo bypass).

Conclusions. Thus, in the presence of indications for performing simultaneous operations on coronary and brachiocephalic arterial pools in patients with high surgical risk, off pump coronary artery bypass is a justified method with an acceptable profile of efficacy and safety in a specialized hospital with an experienced surgeon and a trained operating team.