LONG-TERM RESULTS OF THREE STRATEGIES OF SURGICAL MYOCARDIAL REVASCULARIZATION IN ISCHEMIC HEART DISEASE AND MULTIVESSEL CORONARY DISEASE

Aim. To analyze the 30-day and long-term results of three strategies of surgical myocardial revascularization in patients with multivessel coronary disease with stable forms of ischemic heart disease. Materials and Methods. The study included 155 patients randomized into 3 groups of myocardial revascularizations: «hybrid revascularization», «coronary artery bypass grafting (CABG)» and «percutaneous coronary intervention (PCI)». In the «hybrid revascularization» group, the first stage was a minimally invasive direct revascularization of the myocardium with anterior descen-ding coronary artery followed (within 1-3 days) by PCI of other coronary vessels with implantation of second-generation «Xience» drug-eluting stents. In the groups of CABG and PCI, coronary artery bypass grafting and percutaneous coronary intervention with use of Xience stents, respectively, were conducted. In all the three groups the success of the procedure and the frequency of the main adverse cardiovascular events were evaluated. Results. A comparative analysis of the primary (residual myocardial ischemia according to scintigraphy with pharmacological load in 12 months after myocardial revascularization) and secon-dary (significant adverse cardiovascular events) end points is presented. The immediate and long-term results of the frequency of the main adverse cardiovascular events of the hybrid myocardial revascularization group turned out to be comparable with those of the PCI and CABG groups. Conclusion. Hybrid coronary myocardial revascularization is the method of choice in the treatment of patients with multivessel coronary artery disease and with stable forms of coronary artery disease.