Hospital outcomes of transaortic implantation of the «MedLAB-CT» prosthesis in patients with combined coronary artery disease: a single-center study

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Introduction. Aortic valve replacement (AVR) is one of the most frequently performed procedures in cardiac surgery, which significantly improves the quality of life and increases its duration. Recently, transcatheter aortic valve implantation (TAVI) has been actively used, which is especially important in patients with concomitant pathology, in particular coronary heart disease (CHD). In this article, we describe the experience of successful surgical treatment of patients who underwent TAVI in combination with coronary artery bypass grafting. Aim: To compare the results of open transaortic implantation of the “MedLAB–CT” prosthesis in combination with coronary bypass surgery, in comparison with similar indicators when replacing the aortic valve with a mechanical prosthesis with coronary artery bypass grafting, at the hospital stage. Material and Methods. Patients operated in the clinic from June 2020 to November 2023. A retrospective observational comparison of the results of surgical treatment of two groups of patients was performed: Group 1 study group, which consisted of 60 patients who underwent open transaortic implantation of the prosthesis “MedLAB-CT” in combination with CABG. Group 2 control group, it included 99 patients who underwent AVR with a mechanical prosthesis and CABG. Using the Propensity Score Matching (PSM) pseudorandomization method, 60 patients were selected from the comparison group. Results. Cardiopulmonary bypass time was significantly less in the “MedLAB-CT” + CABG group – 57.4 ± 8.3 min (p = 0.003). A statistical difference in the time of aortic clamping was revealed: in the study group had a value of 43.2 ± 5.2 min, in the comparison group 75.4 ± 9.2 min (p = 0.002). There were no statistically significant differences in the duration of surgery (p = 0.224), length of stay in the intensive care unit (p = 0.805) and hospitalization (p = 0.783). Conclusion. The proposed method of open transaortic implantation of the MedLAB-CT prosthesis in combination with coronary bypass surgery can significantly reduce the time of cardiopulmonary bypass and myocardial ischemia, which has a positive effect on the course of the postoperative period.

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