SURGICAL TREATMENT OF CHD PATIENTS WITH REDUCED CONTRACTILE ABILITY OF MYOCARDIUM OF THE LEFT VENTRICLE
Abstract
The increased worldwide interest in performing coronary artery bypass grafting operations on a beating heart has made the question of the results of these operations in patients with low contractility of the left ventricular myocardium belonging to the high-risk category urgent. The aim of our study was a comparative assessment of the immediate results of surgical treatment of patients with reduced (LVEF <45%) and normal myocardial contractility, operated under MIRM conditions. Materials and methods. A comparative analysis of the immediate results of surgical treatment of 302 patients with coronary artery disease who underwent beating heart bypass surgery was carried out. Most of the patients were men (81.3%). The average age of the general group was 59.2 ± 7.4 years. The patients were divided into two groups - patients with LVEF less than 45% - 49 patients (16%) and patients with LVEF more than 45% - 253 people (84%). Results. Despite the fact that for a number of clinical indicators (concomitant diseases), we obtained a statistically significant difference - arterial hypertension, BCA lesion, mean LVEF, according to the main hemodynamic criteria, such as - unstable angina pectoris, middle class according to CCS and NYHA, the number of women in group, lesion of the trunk of the LCA and multivessel coronary artery disease, we did not reveal statistically significant differences between our groups. Nevertheless, the initial degree of operational risk according to EuroSCORE II was significantly higher in the first group of patients - with a low left ventricular ejection fraction. Conclusions. Our results of a comparative assessment of two groups of patients - with reduced LV ejection fraction (less than 45%) and with normal contractile ability, who underwent minimally invasive myocardial revascularization, showed the high efficiency of this type of surgical treatment.