Тотальная артериальная реваскуляризация миокарда

В обзорной статье изложено современное представление о тотальной артериальной реваскуляризации миокарда, приведены основные исследования в этой области и современные рекомендации, а также описаны наиболее часто используемые технические варианты, которые позволяют судить о высокой эффективности данной процедуры. Вместе с тем, в медицинском сообществе сохраняется определённая доля недоверия в отношении проведения коронарного шунтирования с использованием только артериальных кондуитов, и даже в обоснованных случаях, когда выбор очевиден, процент проведения указанных операций невелик. Это связано как с технически более трудоёмкими манипуляциями, так и с определёнными факторами риска, способствующими более сдержанному подходу в широком использовании тотальной артериальной реваскуляризации миокарда.

1. Tomoaki S. Optimal use of arterial grafts during current coronary artery bypass surgery. Surg Today. 2018; 48(3):264-273doi: 10.1007/s00595-017-1565-z.

2. Хелимский Д. А., Шермук А. А., Крестьянинов О.В., Покушалов Е.А., Караськов А.М. Эндоваскулярные вмешательства при хронической окклюзии коронарных артерий. Комплексные проблемы сердечно-сосудистых заболеваний. 2017; (1): 58-64. doi: 10.17802/2306-1278-2017-1-58-64.

3. Carrel T., Winkler B. Current trends in selection of conduits for coronary artery bypass grafting. Gen Thorac Cardiovasc Surg. 2017; 65(10): 549-556. doi: 10.1007/s11748-017-0807-8.

4. Head S. J., Milojevic M., Taggart D. P, Puskas J.D. Current Practice of State-of-the-Art Surgical Coronary Revascularization. Circulation. 2017; 136 (14): 1331-1345. doi: 10.1161/circulationaha.116.022572.

5. Papakonstantinou N., Baikoussis N. Total arterial revascularization: A superior method of cardiac revascularization. Hellenic J. Cardiol. 2016; 57(3): 152-156. doi: 10.1016/j.hjc.2016.06.002.

6. Brenda Martmez-Gonzalez, Cynthia Guadalupe Reyes-Hernandez, Alejandro Quiroga-Garza Conduits Used in Coronary Artery Bypass Grafting: A Review of Morphological Studies. Ann Thorac Cardiovasc Surg 2017; 23: 55-65. doi: 10.5761/atcs.ra.16-00178.

7. Вечерский Ю. Ю., Затолокин В. В., Андреев С. Л., Скурихин И.М., Шипулин В.М. Технические аспекты аутоартериального коронарного шунтирования. Сибирский медицинский журнал. 2015; 30 (2):65-68.

8. Edelman J. J., Sherrah A. G., Wilson M. K.. Anaortic, total-arterial, off-pump coronary artery bypass surgery: why bother? Heart Lung Circ. 2013; 22(3): 161-70. doi: 10.1016/j.hlc.2012.09.005.

9. Guo-Wei He, editor. Arterial grafting for coronary artery bypass surgery. Berlin: Springer-Verlag; 2006. DOI https://doi.org/10.1007/3-540-30084-8

10. Samak M., Fatullayev J., Sabashnikov A. Total Arterial Revascularization: Bypassing Antiquated Notions to Better Alternatives for Coronary Artery Disease. Med Sci Monit Basic Res. 2016; 22: 107-114.

11. Di Franco A., Sarullo F. M., Gaudino M. Multiple arterial grafting and ostriches: let's all take heart! Oncotarget. 2017; 8(49): 84622-84623. doi: 10.18632/oncotarget.21392.

12. Rastan A. J. Treatment of Coronary Artery Disease: Randomized Trials on Myocardial Revascularization and Complete Arterial Bypass Grafting. Thorac Cardiovasc Surg. 2017; 65(S 03): S167-S173. doi: 10.1055/s-0037-1601375.

13. Акчурин РС., Ширяев А.А., Васильев В.П., Галяутди-нов Д.М., Власова Э.Е. Современные тенденции в коронарной хирургии. Патология кровообращения и кардиохирургия. 2017; 21(3S): 34-44. doi: http://dx.doi.org/10.21688/1681-3472-2017-3S-34-44

14. Taggart D., Amin S., Djordjevic J. et al. Prospective study of external stenting of saphenous vein grafts to the right coronary artery: the VEST II study. Eur J Cardiothorac Surg.2017 May 1; 51(5): 952-958. doi: 10.1093/ejcts/ezw438.

15. Dashwooda M. R, Tsui J. C. ‘No-touch’ saphenous vein harvesting improves graft performance in patients undergoing coronary artery bypass surgery: A journey from bedside to bench. Vascul Pharmacol. 2013; 59(1-2): 52. doi: 10.1016/j.vph.2012.07.008.

16. Taggart D. P., Altman D. G., Flather M. Associations Between Adding a Radial Artery Graft to Single and Bilateral Internal Thoracic Artery Grafts and Outcomes: Insights From the Arterial Revascularization Trial. Circulation. 2017; 136(5): 454-463. doi: 10.1161/CIRCULATIONAHA.117.027659.

17. Bisleri G., Bacco L., Giroletti L., Muneretto С. Total arterial grafting is associated with improved clinical outcomes compared to conventional myocardial revascularization at 10 years follow-up. Heart Vessels.2017; 32(2): 109-116. doi: 10.1007/s00380-016-0846-6.

18. Tatoulis J., Wynne R., Skillington PD. Total Arterial Revascularization: A Superior Strategy for Diabetic Patients Who Require Coronary Surgery. Ann Thorac Surg. 2016c; 102(6): 1948-1955. doi: 10.1016/j.athoracsur.2016.05.062.

19. Janiec M., Dimberg A., Nazari Shafti T.Z., Lagerqvist B., Lindblom R.P.F. No improvements in long-term outcome after coronary artery bypass grafting with arterial grafts as a second conduit: a Swedish nationwide registry study. Eur J Cardiothorac Surg. 2018; 53 (2): 448-454. doi: 10.1093/ejcts/ezx280.

20. Вечерский Ю. Ю., Андреев С. Л., Затолокин В. В. Сравнительное исследование функционирования различных аутоартериальных и венозных графтов по данным шунтографии после изолированного коронарного шунтирования. Сибирский медицинский журнал. 2010; 25 (4):43-49.

21. Чвоков А.В., Шиленко П.А., Молочков А.В., Сидоров Р.В., Жбанов И.В., Бимаммарное шунтирование при диффузном поражении коронарных артерий у больных ишемической болезнью сердца и сахарным диабетом. Вестник Национального медико-хирургического Центра им. Н.И. Пирогова. 2012; 7 (3): 21-23.

22. Cuminetti G., Gelsomino S., Curello S. Contemporary use of arterial and venous conduits in coronary artery bypass grafting: anatomical, functional and clinical aspects. Neth Heart J. 2017; 25(1): 4-13. doi: 10.1007/s12471-016-0919-2

23. Fan T., Feng Y., Feng F. A comparison of postoperative morphometric and hemodynamic changes between saphenous vein and left internal mammary artery grafts. Physiol Rep. 2017; 5(21): e13487. doi: 10.14814/phy2.13487

24. Persson M., Sartipy U. Bilateral Versprimus Single Internal Thoracic Artery Grafts. Current Cardiology Reports. 2018; 20: 4. doi: 10.1007/s11886-018-0947-1

25. Prim D.A., Zhou B., Hartstone-Rose A. A mechanical argument for the differential performance of coronary artery grafts. J Mech Behav Biomed Mater. 2016; 54: 93-105. doi: 10.1016/j.jmbbm.2015.09.017

26. Malinska A., Podemska Z., Perek B. et al. Preoperative factors predicting saphenous vein graft occlusion in coronary artery bypass grafting: a multivariate analysis. Histochem Cell Biol. 2017; 148: 417-424. doi: 10.1007/s00418-017-1574-4.

27. Ji Q., Xia L., Shi Y. Mid-term graft patency of right versus left internal mammary artery as arterial conduit usage for left anterior descending artery revascularisation: Insights from a single-centre study of propensity-matched data. Int J Surg. 2017; 48: 99-104. doi: 10.1016/j.ijsu.2017.10.037.

28. Taggart D. P. Current status of arterial grafts for coronary artery bypass grafting. Ann Cardiothorac Surg. 2013; 2(4): 427430. doi: 10.3978/j.issn.2225-319X.2013.07.21.

29. Tatoulis J., Buxton B.F., Fuller J.A. Long-term patency of 1108 radial arterial-coronary angiograms over 10 years. Ann Thorac Surg. 2009; 88(1): 23-9. doi: 10.1016/j. athoracsur.2009.03.086.

30. Cao C., Manganas C., Horton M.. Bannon P., Munkholm-Larsen S., Ang S.C., Yan T.D. Angiographic outcomes of radial artery versus saphenous vein in coronary artery bypass graft surgery: A me-ta-analysis of randomized controlled trials. J Thorac Cardiovasc Surg, 2013; 146: 255-61. doi: 10.1016/j.jtcvs.2012.07.014.

31. Tranbaugh R.F., Dimitrova K.R., Friedmann P., Geller C.M., Harris L.J., Stelzer P. et al: Coronary artery bypass grafting using the radial artery: Clinical outcomes, patency, and need for reintervention. Circulation. 2012; 126: S170-75. doi: 10.1161/CIRCULATIONAHA.111.083048.

32. Suzuki T., Asai T., Nota H. Early and long-term patency of in situ skeletonized gastroepiploic artery after off-pump coronary artery bypass graft surgery. Ann Thorac Surg. 2013l; 96(1): 90-5. doi: 10.1016/j.athoracsur.2013.04.018

33. Suma H. The Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting: A 30-Year Experience. Korean J ThoracCardiovasc Surg. 2016; 49(4): 225-31. doi: 10.5090/kjtcs.2016.49.4.225.

34. Hillis L.D., Smith P.K., Anderson J.L., Bittl J.A., Bridges C.R., Byrne J.G. et al. ACCF/AHA guideline for coronary artery bypass graft surgery: a report of the American College of Cardiology Foundation/American Heart Association. Circulation. 2011; 124(23):2610-42. doi: 10.1161/CIR.0b013e31823b5fee.

35. Neumann F.J., Sousa-Uva M., Ahlsson A. et al. ESC/ EACTS guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS): developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European Heart Journal. 2018; 00: 1-96. doi:10.1093/eurheartj/ehy394.

36. Aldea G.S, Bakaeen F.G., Pal J., Fremes S., Head S.J., Sabik J. et al. The Society of Thoracic Surgeons clinical practice guidelines on arterial conduits for coronary artery bypass grafting. Ann Thorac Surg. 2016; 101 (2): 801-809. doi: 10.1016/j.athoracsur.2015.09.100.

37. Yuan S.M., Shinfeld A., Raanani E. Configurations and classifications of composite arterial grafts in coronary bypass surgery. J Cardiovasc Med (Hagerstown). 2008; 9(1): 3-14. doi: 10.2459/JCM.0b013e3280110628.

38. Buxton B.F, Hayward P.A. The art of arterial revascularization - total arterial revascularization in patients with triple vessel coronary artery disease. Ann Cardiothorac Surg. 2013; 2(4): 543-51. doi: 10.3978/j.issn.2225-319X.2013.07.14.

39. Buttar S.N., Yan T.D., Taggart D.P. Long-term and short-term outcomes of using bilateral internal mammary artery grafting versus left internal: a meta-analysis. Heart. 2017; 103(18): 1419-1426. doi: 10.1136/heartjnl-2016-310864.

40. Tagusari O., Kobayashi J., Bando K. Total Arterial Off-Pump Coronary Artery Bypass Grafting for Revascularization of the Total Coronary System: Clinical Outcome and Angiographic Evaluation. Ann Thorac Surg 2004;78:1304-11. doi: 10.1016/j.athoracsur.2004.03.094

41. Watson R.A., Hamza M., Tsakok T.M. Radial artery for coronary artery bypass grafting: does proximal anastomosis to the aorta or left internal mammary artery achieve better patency? Interact Cardiovasc Thorac Surg. 2013; 17(6): 1020-1024. doi: 10.1093/icvts/ivt346.

42. Hayward P.A., Buxton B.F. Mid-term results of the Radial Artery Patency and Clinical Outcomes randomized trial. Ann Cardiothorac Surg. 2013; 2(4): 458-66. doi: 10.3978/j. issn.2225-319X.2013.07.18.

43. Formica F., Ferro O., Greco P. Long-term follow-up of total arterial myocardial revascularization using exclusively pedicle bilateral internal thoracic artery and right gastroepiploic artery. Eur J Cardiothorac Surg. 2004;26(6):1141-8. doi: 10.1016/j.ejcts.2004.08.027

44. Suzuki T., Asai T., Matsubayashi K. In off-pump surgery, skeletonized gastroepiploic artery is superior to saphenous vein in patients with bilateral internal thoracic arterial grafts. Ann Thorac Surg. 2011; 91(4): 1159-64. doi: 10.1016/j.athoracsur.2010.12.031.

45. Massimo L., Innorta A., Pettinari M. Flow dynamics and wall shear stress in the left internal thoracic artery: composite arterial graft versus single graft. European Journal of Cardio-thoracic Surgery. 2006; 29 473-478. doi: 10.1016/j.ejcts.2006.01.035

46. Mannacio V., De Vita A., Antignano A. Y grafts with the left internal mammary artery and radial artery. Midterm functional and angiographic results. Cohort study. Int J Surg.2014; 12(9): 952-7.

47. Wi J.H., Joo H.C., Youn Y.N.. Comparison of Radial Artery and Saphenous Vein Composite Y Grafts during Off-pump Coronary Artery Bypass. Korean J ThoracCardiovasc Surg. 2013; 46(4): 265-73. doi: 10.1016/j.ijsu.2014.07.008.

48. Guerciotti B., Vergara C., Ippolito S. A computational fluid-structure interaction analysis of coronary Y-grafts. Med Eng Phys. 2017; 47:117-127. doi: 10.1016/j.medengphy.2017.05.008.

49. Kikuchi K., Une D., Endo Y. Minimally Invasive Coronary Artery Bypass Grating Using Bilateral In Situ Internal Thoracic Arteries. Ann Thorac Surg. 2015;100:1082-4. doi: 10.1016/j.athoracsur.2014.11.056.

50. Rodriguez M.L., Lapierre H.R., Sohmer B. MidTerm Follow-up of Minimally Invasive Multivessel Coronary Buxton B. Artery Bypass Grafting. Is the Early Learning Phase Detrimental? Innovations. 2017 March/April; 12 (2): 116-120.

51. Lemma M., Atanasiou T., Contino M. Minimally invasive cardiac surgery-coronary artery bypass graft. Multimed Man Cardiothorac Surg. 2013;2013: mmt007. doi: 10.1093/mmcts/mmt007.