Compare strategies of performing coronary artery bypass grafting in patients with ischemic heart disease and multivessel coronary artery disease underwent stenting of the infarct-dependent artery with baremetall stents
Objective: to compare the long-term results of two strategies for performing coronary artery bypass grafting (CABG) in patients with coronary heart disease and multivessel lesions, which performed stenting of the holometallic stents of the clinical-dependent artery for acute coronary syndrome. Material and methods. The results of two-year follow-up of patients who underwent stenting of the clinical-dependent artery with the use of holometallic stents for acute coronary syndrome by transradial access and the second stage-coronary artery bypass grafting were analyzed. The main group consisted of 51 patients who underwent aortocoronary bypass surgery and had a mammary-coronary shunt placed proximal to the implanted stent. The control group included 46 patients, in this group mammary-coronary bypass graft was placed distal to the implanted stent. At the time of performing coronary artery bypass grafting stents in both groups were passable. In both groups, the following end points were analyzed: cardiovascular mortality, myocardial infarction, acute cerebrovascular accident, re-revascularization and combined MACCE end point (cardiovascular mortality, myocardial infarction, acute cerebrovascular accident, re-revascularization). Results. The analysis of the results revealed statistically significant differences between the main and control groups in the frequency of repeated revascularization (25.5 and 2.2%, respectively), the return of the angina clinic (27.5 and 8.7%, respectively) and the combined MACCE point (31.4 and 6.5%, respectively). Conclusion. When performing aortocoronary bypass grafting anastomosis distal to the stented area is the preferred strategy of revascularization. The type of coronary stents implanted for acute coronary syndrome is an additional independent factor that determines the long-term results of CABG.