Results of coronary artery bypass grafting using the beating heart technique in patients with severe chronic obstructive pulmonary disease

Introduction. The combination of coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD) in patients referred for coronary artery bypass grafting (CABG) is associated with a high risk of postoperative respiratory complications. Objective. To determine the features of surgical treatment of patients with combined CAD and COPD, to evaluate the results of interventions in off pump and on pump CABG, and to identify the optimal management strategy for such patients. Materials and methods. The study included 100 patients who underwent CABG in 2020–2024. All patients had COPD. In group I (n=50), operations were performed off pump; in group II (n=50), operations were performed on pump with cardioplegia. Discussion. The data obtained indicate that the advantage of surgery on a working heart in patients with COPD is achieved primarily by reducing respiratory complications, especially in patients with severe disease, and is accompanied by a lower annual mortality rate. Results. Group I had fewer complications: prolonged mechanical ventilation, pneumonia, respiratory failure, mediastinitis. The incidence of respiratory complications (pneumonia, prolonged ventilation) was lower in group I compared to group II. Complications from other organs and systems were also higher in group II than in group I. Conclusion. Minimized surgical myocardial revascularization off pump in patients with COPD reduces the number of respiratory complications and improves early postoperative outcomes.