MORPHOLOGICAL AND ANGIOGRAPHIC ASSESSMENT OF AUTOVENOUS CONDUIT WITH VARIOUS METHODS OF ISOLATION FOR CORONARY ARTERY BYPASS GRAFTING
Introduction: Ischemic heart disease remains one of the leading causes of death worldwide. Treatment options for coronary artery disease include conservative treatment, percutaneous coronary intervention, and coronary artery bypass grafting (CABG). Since the beginning of the 1990s, the technique for preparing a large saphenous vein, in which conduit was taken together with the surrounding tissue, was called “no-touch” (NT). This method provides a greater degree of patency, preservation of the function of the left ventricle, and an improved clinical result, compared with the traditional fence both in the short and long term.
The purpose of the research: сonduct a comparative analysis of conduit patency, taken in the traditional way and gentle method (no-touch).
Materials and research methods: In the clinic of the regional cardiology center in Pavlodar from January to November 2017, used a new technology for low-traumatic vein explantation for CABG in patients with coronary artery disease. The methods of descriptive and comparative statistics were used. To assess the changes that occur during vein explantation according to our proposed technology and the traditional method, 69 fragments of the saphenous vein of the femor (BPV) of the patients were used. To compare the trauma of both methods, light microscopy of vein fragments was used. A morphological study of 69 fragments of the large saphenous vein was carried out: 35 sections of veins taken according to the classical method, and 34– using low-traumatic technology. The study involved 33 (94.2%) patients in the classical method group and 31 (91.1%) patients in the low-traumatic method group. The patency of 64 autovenous shunts was studied (33 after the classical method, 31 after none touch).
Statistical processing the results of the study was carried out using the SPSS program. The statistical significance of differences was determined by using the Mann-Whitney method to compare groups.To compare frequency indicators, Pearson's x2 criterion was used. The boundary level of significance of differences for the refutation of the null hypothesis was taken p <0.05.
Results: The permeability of shunts after the no touch method was 96%, (which is comparable with the result of the functioning of the anterior interventricular artery), after 82% of the classical method was taken. In the study of morphological changes in the vascular wall of the vein in the process of its isolation by the “no touch” method, it was noted that the endothelial surface basically retained its integrity and folding compared to the conventional method. Total desquamation of the endothelium is characteristic of the classical method and was found in 15% of cases.
Conclusions: The "no touch" method provides a high level of patency of venous grafts and is comparable with the level of patency of the anterior interventricular artery.
Arman M. Kurmanov 1, Sabit M. Zhusupov 1,
Karlygash A. Naresheva 2, Timur A. Raimkhanov 2
1 NCJSC "Medical University of Semey", Semey, Republic of Kazakhstan;
2 Regional cardiological center, Pavlodar city, Republic of Kazakhstan.
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Kurmanov A.M., Zhusupov S.M., Naresheva K.A., Raimkhanov T.A. Morphological and angiographic assessment of autovenous conduit with various methods of isolation for coronary artery bypass grafting // Nauka i Zdravookhranenie [Science & Healthcare]. 2019, (Vol.21) 6, pp. 49-55.Related publications:
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