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Zenkov A.A.1,2
Life quality analysis on the application of different methods of surgical myocardial revascularization: prospective randomized trial MICSREVS
1Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2018;17(1):68-80.

Objectives. To evaluate the health-related quality of life (HRQOL) of the coronary heart disease patients while applying different methods of surgical myocardial revascularization in the prospective randomized controlled trial «Minimally Invasive Cardiac Surgery Revascularization Strategy» (MICSREVS), which compared the effectiveness of minor invasive cardiac surgery of coronary artery bypass grafting (MICS-CABG) versus off-pump coronary artery bypass grafting (OPCABG) and on-pump coronary artery bypass grafting (ONCABG).
Material and methods. In accordance with its design (, the trial was carried out involving 3 parallel groups with 50 persons in each of them. In the main group the MICS-CABG strategy was aimed at the performance of multivessel full arterial revascularization on the beating heart using the aortic no-touch technique via the left minithoracotomy. In the second (OPCABG) and the third (ONCABG) groups of the patients conventional myocardial revascularization was performed via the median sternotomy.
Results. No significant differences between the groups were observed concerning their pain intensity in 1 (46,0±7,7, 43,7±7,3 and 44,0±8,0 scores) and 4 (27,6±7,4, 26,1±6,3 and 25,4±6,8 scores, respectively) days postoperatively as determined by means of visual analog scale (р>0,1). MICS-CABG was associated with much less median time of the return to full physical activity (14 (7; 14), 56 (56; 70) and 56 (56; 84) days, respectively, р˂0,001), more positive postoperative integral parameters of physical component of HRQOL vs. ONCABG (р=0,020), as well as mental component of HRQOL vs. OPCABG (р=0,039) and ONCABG (р=0,044) in two months after the surgical intervention.
Conclusions. Comparable with conventional myocardial revascularization pain intensity at the early postoperative period against the background of continuous regional intercostal analgesia and significantly higher rates of HRQOL in the short term after surgery is observed on MICS-CABG.
Key words: coronary heart disease, minor invasive coronary artery bypass grafting, minimally invasive myocardial revascularization, quality of life, visual analog scale, pain intensity.


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Information about authors:
Zenkov A.A. – Candidate of Medical Sciences, head of the cardiovascular department of Vitebsk Regional Clinical Hospital, associate professor of the Chair of Surgery of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210037, Vitebsk, 37 Voinov-Internatsionalistov str., Vitebsk Regional Clinical Hospital, the cardiovascular department. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Alexander A. Zenkov.

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