Kupchiskiy O. Surgical treatment of ischemic heart disease without using cardiopulmonary bypass

Dissertation is devoted to the problem of surgical treatment of ischemic heart disease without the use of cardiopulmonary bypass (CPB). Estimation of the results of operations of the coronary artery bypass grafting (CABG) without the use of CPB allowed to define indications and contraindications to them, to extend the contingent of patients for which the traditional CABG operations with the use of CPB are accompanied the promoted risk of development of complications. The optimum methods of expositioning of heart and stabilizing of coronary arteries are developed. On the basis of study of changes of hemodynamic parameters during the different stages of operation, estimation of preoperative coronarography data, the analysis of specialities of the intraoperative stage the algorithm of optimum sequence of coronary artery bypass grafting is developed. The features of the anaesthesiological providing of CABG operations without the use of CPB are certain. The considerable decline of frequency of postoperativecomplications is attained as compared to the CABG operations with the use of CPB. The study of long term results testifies to high stability of effect of operations in both groups of patients. Survival in long terms after an operation for certain did not differ in groups of patients and was to 5 year a supervision 83,2% for patients operated with the use of CPB and 87,5% for patients operated on a beating heart. The result of application of method of coronary bypass grafting on a beating heart was become by the considerable decline of hospital mortality which for period from April 2000 for April 2004 was 0.7%.