Introduction. The number of patients who need of repeated operations on coronary arteries in connection with dysfunction shunts or progression of atherosclerosis, is constantly increasing throughout the world and in Russia, due to the constant growth of population the operated patients. Repeated redo coronary artery bypass surgery (CABG) remains difficult and associated with a higher risk of morbidity and mortality compared to primary CABG. High risk redo CABG largely due to technical difficulties. Many publications show a significant risk of injury during the repeated access to the heart, where the incidence of intraoperative trauma mediastinum organs and structures occur in 5–10% of cases. The listed disadvantages resternotomy have led to the development of alternative approaches to heart, including the execution of redo CABG. The purpose of this message is to provide immediate results re-myocardial revascularization through thoracotomy of 22 patients, who have return angina after previously CABG and design our algorithm for repeated operations.
Material and methods. For the period January 2015 to 2018 May in Bakoulev National Medical Research Center for Cardiovascular Surgery 22 redo CABG operations performed from alternative approaches (15 on a beating heart and 7 under peripheral extracorporeal circulation).
Results. Death and myocardial infarction was not. The average bed day amounted to 7,2.
Conclusion. Redo CABG via thoracotomy in patients with return angina after CABG lead to better direct results of surgical treatment:
a decrease in the frequency of acute myocardial infarction, congestive heart failure, stroke, hospital mortality, reoperation about the
bleeding, of post-operative cardiac arrythmias, transfusions, reducing the time of mechanical ventilation and bed-days.
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About the authors
- Leo A. Bockeria, Academician of RAS and RAMS, Director; orcid.org/0000-0002-6180-2619
Igor’ Yu. Sigaev, Dr. Med. Sc., Professor, Head of Department; orcid.org/0000-0002-1323-8072
Artak V. Kazaryan, Cand. Med. Sc., Senior Researcher; orcid.org/0000-0003-4277-7961
Maksim V. Starostin, Cand. Med. Sc., Senior Researcher; orcid.org/0000-0003-0169-9274
Milena A. Keren, Dr. Med. Sc., Researcher, Cardiologist; orcid.org/0000-0003-2428-1559
Beka D. Morchadze, Cand. Med. Sc., Researcher; orcid.org/0000-0002-0385-2765
Ivan V. Pilipenko, Cardiovascular Surgeon; orcid.org/0000-0002-2461-052X
Pеtr V. Gusev, Researcher; orcid.org/0000-0002-9287-2695
Igor’ F. Kudashev, Junior Researcher; orcid.org/0000-0001-8633-0972