EXPERIENCE IN EARLY REHABILITATION OF PATIENTS AFTER CORONARY ARTERY BYPASS GRAFT SURGERY

Vlasova E.E., Komlev A.E., Vasiliev V.P., Shiryaev A.A., Lepilin M.G., Akchurin R.S.
Cardiovascular Surgery Department Scientific Research Institute of Clinical Cardiology named after A.L. Myasnikov Russian Cardiological Research-and-Production Complex under the Russian Federal Agency on High-Technology Medical Care,
Moscow, Russia

A strategy of rapid in-hospital postoperative rehabilitation is currently a priority trend in managing the patients after coronary artery bypass graft (CABG) surgery.

Objective. To investigate the baseline characteristics and peculiarities of perioperative treatment of patients with a short period of in-hospital rehabilitation.

Materials and methods. We studied a total of 690 patients who had endured CABG operations according to the conventional technique performed over the period from January 2007 to August 2008. The procedures of preoperative preparation, surgical intervention and postoperative management both at the stage of the intensive care unit (ICU) and at the Cardiosurgical Department in all the patients were carried out in accordance with the accepted protocol.

Results. The Study Group (Group 1) comprised a total of eighty-three 39-to-79-year-old (average age 55.7±7.9 years) patients whose postoperative hospital stay amounted to 8.1±1.3 days. Of these, there were 76 men and 7 women. The Comparison Group (Group 2) was composed of one hundred 39-to-76-year-old (mean age 56.2±8.3 years) patients, with 89 men and 11 women enrolled. The duration of the postoperative hospital stay in the Comparison Group amounted to 12±1.4 days (p<0.05). All the operated patients according to the findings of coronary angiography (CAG) had had haemodynamically significant atherosclerotic lesions of three and more coronary arteries. The patients in both Groups were comparable by the main clinical characteristics. There were no patients with recently sustained myocardial infarction, unstable angina, or left-ventricular aneurysms in either of the groups studied.

Conclusions. Employing the protocol we devised makes it possible to reduce the postoperative hospital stay to 7 days in electively operated patients presenting with a stable course of coronary artery disease (CAD), without pronounced co-existing pathology, with a satisfactory left-ventricular systolic function, with preoperatively compensated diabetes mellitus (DM) and adequately controlled arterial hypertension (AH).

KEY WORDS: coronary artery bypass grafting, rehabilitation.

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