On-pump beating heart coronary artery bypass grafting in patients with reduced left ventricular contractility

The article features a comparative evaluation of the effectiveness of on-pump beating heart coronary artery bypass grafting and myocardial revascularization with cardioplegia, the dynamics of metabolic changes in myocardium during these operations. It was found that hyperlactatemia in coronary sinus blood, which is observed throughout the coronary artery bypass surgery with cardioplegia, suggests long-term structural and metabolic disturbances in the myocardium due to anoxia and reperfusion syndrome. On-pump beating heart coronary artery bypass grafting is accompanied by a less pronounced and transient changes in myocardium metabolism. On-pump beating heart coronary artery bypass grafting in patients with normal left ventricular contractility has advantages over myocardial revascularization with cardioplegic. In patients with reduced left ventricular contractility, conducting on-pump beating heart coronary artery bypass grafting leads to a significant reduction in the incidence of acute heart failure in the perioperative period.