Objectification of the characteristics of the distal bed of shunting vessels with diffuse atherosclerotic lesions in coronary surgery

Abstract

Objective. Hospital results of coronary artery bypass grafting (CABG) in patients with diffuse coronary artery disease and effectiveness of coronary diffuse lesion index (DLI) assessments are the aims of this article.

Materials and methods. Patients who underwent CABG in 2014 were included in the study. 89patients with diffuse coronary artery disease formed group 1. A group 2 included 91 patients with proximal lesions. Each distal anastomosis was formed under the surgical microscope. Preoperative clinical status and angiographic picture were analyzed. DLI measurement was based on three parameters: atherosclerosis severity, diameter of coronary artery and weight of myocardium supplying. Hospital results and bypass angiography in patients with recurrence angina were assessed.

Results. Preoperative clinical status was comparable in both groups. There were no any differences in SYNTAX Score (36 vs 32 in group 1 and 2 respectively, p > 0.05), however DLI in group 1 was higher than in group 2 (4.9 vs 1.8, p < 0.05). Hospital results was the same in study groups. There was tend to graft failure during 1 year after CABG with DLI more 4.

Conclusion. Surgical microscope using allows to perform CABG in patients with diffuse coronary artery disease without any additional risks. It is possible that proposed approach of DLI assessment will help predict “ graft patency in CABG patient, but it needs of follow-up study.