Stratification of the risk of postoperative complications in cardiovascular surgery

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Abstract

The paper presents a mathematical model function to demonstrate the effectiveness of a new method of preoperative risk stratification of adverse cardiovascular events in patients with atherosclerotic lesions of the coronary and internal carotid arteries. The possibility of choosing the revascularization approach based on the interactive calculation of the mathematical probability of the occurrence of a complication was demonstrated. Conclusions about the effectiveness of the method developed were made.

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About the authors

Anton N. Kazantsev

Alexander Hospital

Author for correspondence.
Email: dr.antonio.kazantsev@mail.ru
ORCID iD: 0000-0002-1115-609X

сердечно-сосудистый хирург отделения хирургии № 3 ГБУЗ «Александровская больница»

Russian Federation, 193312, Saint Petersburg

Konstantin P. Chernykh

Alexander Hospital

Email: cvs.doc@yandex.ru
ORCID iD: 0000-0002-5089-5549
Russian Federation, 193312, Saint Petersburg

Mikhail A. Chernyavsky

V.A. Almazov National Medical Research Center

Email: machern@mail.ru
ORCID iD: 0000-0003-1214-0150

MD, PhD, DSc

Russian Federation, 197341, Saint Petersburg

Nonna E. Zarkua

Alexander Hospital; I.I. Mechnikov Northwest State Medical University

Email: tatazarkua@mail.ru
ORCID iD: 0000-0002-7457-3149

MD, PhD

Russian Federation, 193312, Saint Petersburg; 191015, Saint Petersburg

Inomjon Kh. Shukurov

I.I. Mechnikov Northwest State Medical University

Email: Krepteks@mail.ru
ORCID iD: 0000-0001-9933-7778
Russian Federation, 191015, Saint Petersburg

Roman Yu. Lider

Kemerovo State Medical University

Email: aaapppmmmooo@gmail.com
ORCID iD: 0000-0002-3844-2715
Russian Federation, 650056, Kemerovo

Kubach G. Kubachev

I.I. Mechnikov Northwest State Medical University

Email: tatazarkua@mail.ru
ORCID iD: 0000-0002-9858-5355

MD, PhD, DSc, Professor

Russian Federation, 191015, Saint Petersburg

Goderzi Sh. Bagdavadze

Alexander Hospital

Email: gud_777@bk.ru
ORCID iD: 0000-0001-5970-6209
Russian Federation, 193312, Saint Petersburg

Evgeniy Yu. Kalinin

Alexander Hospital

Email: aaapppmmmooo@rambler.ru
ORCID iD: 0000-0003-3258-4365

MD, PhD

Russian Federation, 193312, Saint Petersburg

Tatyana E. Zaitseva

Alexander Hospital

Email: b17@zdrav.spb.ru
ORCID iD: 0000-0001-8971-7558

MD, PhD

Russian Federation, 193312, Saint Petersburg

Alexander E. Chikin

Alexander Hospital

Email: b17@zdrav.spb.ru
ORCID iD: 0000-0001-6539-0386

MD, PhD

Russian Federation, 193312, Saint Petersburg

Yuriy P. Linets

Alexander Hospital

Email: b17@zdrav.spb.ru
ORCID iD: 0000-0002-2279-3887

MD, PhD, DSc, Professor

Russian Federation, 193312, Saint Petersburg

References

  1. National guidelines for the management of patients with brachiocephalic artery disease. Angiology and vascular surgery. 2013;19(2): 4–68. (In Russ).
  2. Kazantsev AN, Sultanov RV, Burkov NN, Leader RYu, Yakhnis EYa, Bukhtoyarova VI, Kazantsev EG. Long-term results of surgical and conservative treatment of patients with occlusal-stenotic lesions of the carotid arteries. Khirurgia. 2020;1:67–73. (In Russ). doi: 10.17116/hirurgia202001167.
  3. Alekyan BG, Pokrovsky AV, Karapetyan NG, Revishvili ASh. Direct results of endovascular treatment in patients with combined lesions of the coronary and internal carotid arteries. Endovascular surgery. 2019;6(1):20–26. (In Russ). doi: 10.24183/2409-4080-2019-6-1-20-26.
  4. Kazantsev AN, Chernykh KP, Zarkua NE, Leader RYu, Kubachev KG, Bagdavadze GSh, et al. A new method of glomus-sparing carotid endarterectomy according to AN Kazantsev: cutting off the internal carotid artery at the site from the external and common carotid artery. Russian journal of cardiology. 2020;25(8):10–17. (In Russ). doi: 10.15829/1560-4071-2020-3851.
  5. Kazantsev AN, Chernykh KP, Leader RYu, Zarkua NE, Kubachev KG, Bagdavadze GSh, et al. Glomus-sparing carotid endarterectomy according to A.N. Kazantsev. Hospital and mid-term results. Circulatory pathology and cardiac surgery. 2020;24(3):70–79. (In Russ). doi: 10.21688/1681-3472-2020-3-70-79.
  6. Pokrovskiy AV, Golovyuk AL. The state of vascular surgery in the Russian Federation in 2018. Angiology and vascular surgery. Application. 2018;25(2):1–40. (In Russ).
  7. Kuzhuget RA, Karpenko AA, Kamenskaya OV, Ignatenko PV, Starodubtsev VB, Postnov VG. Ways to improve the immediate and long-term results of carotid endarterectomy. Angiology and vascular surgery. 2016;22(1):111–117. (In Russ).
  8. Kazantsev AN, Chernykh KP, Zarkua NE, Leader RYu, Kubachev KG, Bagdavadze GSh, et al. “Chik-chirik” carotid endarterectomy. Bulletin of the A.N. Bakuleva RAMS. 2020;21(4):414–428. (In Russ). doi: 10.24022/1810-0694-2020-21-4-414-428.
  9. Kazantsev AN, Tarasov RS, Burkov NN, Shabaev AR, Leader RYu, Mironov AV. Carotid endarterectomy: three-year follow-up in a single-center registry. Angiology and vascular surgery. 2018;24(3):101–108. (In Russ).
  10. Akchurin RS, Shiryaev AA, Galyautdinov DM, Vlasova EE, Vasiliev VP, Ismagilov BR, Balakhonova TV. Immediate results of simultaneous coronary bypass surgery and carotid endarterectomy. Cardiology and cardiovascular surgery. 2017;10(6):4–8. (In Russ). doi: 10.17116/kardio20171064-8.
  11. Chernyavsky MA, Gusev AA, Chernova DV, Yarkov IV, Gordeev ML. Stage treatment of multilevel lesions of the brachiocephalic arteries in combination with coronary and valvular pathology of the heart. Angiology and vascular surgery. 2018;24(2):165–171. (In Russ).
  12. Lysenko AV, Axelrod BA, Grishin AV, Fedulova SV, Belov YuV. Choice of tactics for surgical intervention in patients with bilateral lesion of the carotid arteries and multiple lesions of the coronary bed. Cardiology and cardiovascular surgery. 2018;11(6):71–74. (In Russ). doi: 10.17116/kardio20181106171.
  13. Alekyan BG, Pokrovsky AV, Karapetyan NG, Revishvili ASh. A multidisciplinary approach in determining the frequency of detection of coronary heart disease and treatment strategies in patients with pathology of the aorta and peripheral arteries. Russian Journal of Cardiology. 2019;24(8):8–16. (In Russ). doi: 10.15829/1560-4071-2019-8-8-16.
  14. Spiridonov AA, Pirtskhalaishvili ZK. Comparative evaluation of the results of carotid endarterectomy depending on the methods of plasty. Bulletin NTSSSH them. A.N. Bakuleva RAMS. Cardiovascular diseases. 2006;7(4):68–73. (In Russ).
  15. Bokeria LA, Sigaev IYu, Pirtskhalaishvili ZK, Nikonov SF, Darvish NA, TereshinaYuS. Long-term results of surgical treatment of patients with multifocal atherosclerosis after myocardial revascularization, in combination with carotid endarterectomy. forecast and quality of life. Bulletin NTSSSH them. A.N. Bakuleva RAMS. Cardiovascular diseases. 2010;11(S6):150. (In Russ).
  16. Kazantsev AN, Tarasov RS, Burkov NN, Volkov AN, Grachev KI, Yakhnis EYa, et al. Hospital results of percutaneous coronary intervention and carotid endarterectomy in hybrid and phased modes. Angiology and vascular surgery. 2019;25(1):101–107. (In Russ). doi: 10.33529/angio2019114.

Supplementary files

Supplementary Files
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1. JATS XML
2. Рис. 3. График ROC-кривой.

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3. Рис. 4. Риски развития госпитальных осложнений в группе пациентов с поэтапной хирургической тактикой КШ–КЭЭ, а также при применении в данном контингенте больных трех других типов реваскуляризации.

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4. Рис. 5. Риски развития госпитальных осложнений в группе пациентов с симультанной хирургической тактикой КШ+КЭЭ, а также при применении в данной когорте больных трех других типов реваскуляризации.

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5. Рис. 6. Риски развития госпитальных осложнений в группе пациентов с гибридной хирургической тактикой ЧКВ+КЭЭ, а также при применении в данной когорте больных трех других типов реваскуляризации.

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6. Рис. 7. Риски развития госпитальных осложнений в группе пациентов с поэтапной хирургической тактикой: КЭЭ–КШ, а также при применении в данной когорте больных трех других типов реваскуляризации.

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