Off-pump Coronary Artery Bypass through Ministernotomy in Patients with Diabetes Mellitus
Аннотация
Objective: Estimation of the direct results of off-pump coronary artery bypass through ministernotomy in patients with diabetes mellitus. Methods: We have performed 40 operations off-pump coronary artery bypass. All operations were performed through ministernotomy using myocardial stabilizer. The age of patients varies from 32 to 60 years old. All patients were male. Unstable angina was diagnosed in 15 (37.5%) patients, and the rest of 25 (62.5%) patients had different class of stable angina. Arterial hypertension was present in 38 patients, coronary insufficiency in 11 patients. 34 patients had myocardial infarction in the anamnesis. ECG data revealed ischemia in 25 patients. Echo: left ventricle ejection fraction under 40% in patients, under 50% in 22 patients and the rest of patients had 55%. Blood glucose level was varied from 8 to 15 mmol/L and average mean composed of 11.2 mmol/L. Angiography data revealed single-vessel disease in 25 cases and the other 15 patients had double-vessel disease. Results: In all cases, we performed off-pump coronary artery bypass grafting with use of internal mammary artery in 38 cases. By the means of reducing complications related to the diabetes mellitus in all cases, we performed inferior L-shaped ministernotomy. After operation, patients were extubated from 3 to 4 hours (mean 3.4 hours). Mortality was 0%. After operation, all patients were prescribed insulin infusion. Ejection fraction by Echo increased up to 6.65% on average, 35 (90%) cases revealed improvement on coronary blood supply by ECG data. There was no revealed purulent-inflammatory complications at the nearest-term outcome after operation. Conclusions: Off-pump coronary artery bypass through ministernotomy in patients with diabetes mellitus in accordance with insulin infusion reduces risk of intra- and postoperative complications such as complications of central nervous system and purulent-inflammatory processes. KEYWORD: e-P-05 The authors do not declare any conflict of interest.