Efficiency of the closed contour of the artificial circulation in coronary artery bypass grafting.

Aim: From 2014 to 2015, studies were conducted on the use of a closed contour of artificial circulation on the basis of the National Research Center for Cardiac Surgery in the city of Astana, Kazakhstan.\The purpose of this study was to evaluate how effective the closed and open contours of artificial circulation in reducing the risk of post-operative complications. Methods: The study included 100 patients who underwent surgery for stable angina pectoris of coronary heart disease; they underwent coronary artery bypass surgery. Group 1 included 50 patients, with an average age of 62 ± 8 years, undergoing coronary artery bypass grafting using a closed contour of artificial circulation. Group 2 included 50 patients, with an average age of 62 ± 7 years, underwent aortocoronary bypass using an open contour of artificial circulation. For all the initial indices of the group were homogeneous. The time of aortic clamping in both groups was the same, indicating that the same surgeons performed the operation. Total time of artificial circulation was less in the first group than in the second group (57 min ± 12.5 and 64 min ± 16.7, respectively; P = 0.04), because the reperfusion time was less in Group 1 (20.2 min ± 7 and 23.9 min ± 9, respectively; P = 0.04). The average number of grafts was 3 ± 0.67 in the control group, 3 ± 0.53 in the comparative group. Post-operative analysis of laboratory indicators was taken 6 h after operation. Results: The level of erythrocytes in the first group by the end of 6 h after operation was higher, than in the second group 4.13 × 1012 ± 0.59 and 3.38 × 1012 ± 0.52 (P = 0.001), respectively; the level of hemoglobin (Hb) was 115.04 g/L ± 14.7 and 104.1 g/L ± 11.26 (P = 0.05), respectively; the level of hematocrit was 33.1 ± 3.89 and 29.89 ± 4.06 (P = 0.001), respectively; the level of platelets was 246 ±52 and 199 ± 40 (P = 0.001), respectively; leukocytes, C-reactive protein (CRP) levels, body temperature, respiratory rate, and heart rate are reduction in the first group: The level of leukocytes was 11.67 × 109 ± 3.8 and 14.02 × 109 ± 4.3 (P = 0.03), respectively; the level of CRP was 1.4 mg/dl ± 2.4 and 2.2 mg/dl ± 1.9 (P = 0.04), respectively; body temperature was 36.7 ± 0.33 and 38.1±0.7 (P = 0.01), respectively; respiratory rate in 1 min was 17 ± 1.6 and 20 ± 2.02 (P = 0.01), respectively; and heart rate in 1 min was 69 ± 11 and 75 ± 15 (P = 0.02), respectively. Stay by day of the patient in the hospital in the first group was also less and was 10.14 ± 3.8 and 11.32 ± 4.2 (P = 0.04), respectively. The time the patient spent on artificial ventilation in the first group was less, 486 min ± 125 and 646 ± 213 (P = 0.01), respectively. Conclusion: The closed contour can be confidently applied to patients with complex concomitant diseases, as the risk of a systemic inflammatory response decreases, and the level of red blood remains higher in comparison with the open contour of the artificial circulation. [ABSTRACT FROM AUTHOR]