The effectiveness of intraaortic balloon counter - pulsation used during coronary artery bypass grafting in patients with severe chronic heart failure of ischemic origin


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Abstract

The materials of a retrospective analysis of the results of the surgical treatment of 133 patients with severe chronic heart failure of ischemic genesis who underwent coronary bypass surgery are presented. Three groups of patients were distinguished depending on the method of performing myocardial revascularization - on a working heart, in conditions of cardiopulmonary bypass and cardioplegia, on a working heart in terms of parallel cardiopulmonary bypass. Intraaortic balloon counterpulsation has been used both for prophylactic purposes since the preoperative period and for perioperative correction of acute heart failure. It has been established that the use of this type of mechanical circulation support in the presence of preoperative risk factors cannot ensure the safe execution of coronary artery bypass grafting on a working heart. The preventive use of aortic counterpulsation during coronary artery bypass grafting under conditions of planned cardiopulmonary bypass allows reducing the risk of acute heart failure during the perioperative period. If it is impossible to use it in «high - risk» patients, it should be taken into account that operating on a working heart with cardiopulmonary bypass causes a likelihood of developing heart failure 6.3 times less than with myocardial revascularization under cardiopulmonary bypass and cardioplegia.

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About the authors

G. G Khubulava

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: ggkh07@rambler.ru
Saint-Petersburg, Russia

A. E Sukharev

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

V. N Kravchuk

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

A. M Volkov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

A. I Lyubimov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

E. A Knyazev

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

A. S Kusai

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

D. Yu Romanovskii

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

A. V Biryukov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

V. I Zvoznikov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Saint-Petersburg, Russia

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Copyright (c) 2020 Khubulava G.G., Sukharev A.E., Kravchuk V.N., Volkov A.M., Lyubimov A.I., Knyazev E.A., Kusai A.S., Romanovskii D.Y., Biryukov A.V., Zvoznikov V.I.


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