Controversial aspects of coronary endarterectomy

Minale, C; Nikol, Sigrid; Zander, M; Uebis, R.; Effert, S; Messmer, Bruno J.

doi:10.1016/0003-4975(89)90077-5

Cited by 58 publications

(33 citation statements)

References 12 publications

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“…Brenowitz et al 12 introduced the use in the left arterior descending artery, but they reported a higher immediate mortality, as did others 3,11,13 . These data could not be reproduced by Minale et al 18 or by us, where a similar incidence was shown. We believe that the risk factors and performance of complete myocardial revascularization are more important than sim ply the site where coronary endarterectomy is performed.…”

Section: Discussioncontrasting

confidence: 58%

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Myocardial revascularization with coronary endarterectomy. Stratification of risk factors for early mortality

Atik¹,

Dallan²,

Oliveira³

et al. 2000

Arq. Bras. Cardiol.

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Objective -To determine the risk factors for mortality related to myocardial revascularization when performed in association with coronary endarterectomy. (<0.001; 9.283), female sex (0.01; 3.111), acute myocardial infarction (0.02; 3.546), ejection fraction <35% (<0.001; 5.89), and previous myocardial revascularization (<0.001; 4.295). Methods - Conclusion -Coronary endarterectomy is related to higher mortality, and the risk factors involved are important elements of a poor outcome.

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Section: Discussioncontrasting

confidence: 58%

“…On the other hand, Minale et al 18 found different results when studying patency and changes in segmentary contractility after performing 728 coronary endarterectomies. Patency of the arteries undergoing endarterectomy was much lower than that of the arteries where this procedure was not used (45% versus 73.8%).…”

Section: Discussionmentioning

confidence: 99%

Myocardial revascularization with coronary endarterectomy. Stratification of risk factors for early mortality

Atik¹,

Dallan²,

Oliveira³

et al. 2000

Arq. Bras. Cardiol.

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“…However, even after half a century, the current opinions about the safety and effectiveness of CE are varied, and the technique remains controversial. Although it is the only surgical technique that can resolve severe diffuse calcified coronary lesions, it can also lead to increased perioperative morbidity and mortality, and there are reports that it is not advantageous to long-term survival [6,7,10]. Studies show the mortality after CE to be 0% to 15% [6,[11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…However, there is division of opinion among many surgeons about the safety and effectiveness of the technique; although proponents claim that it is the last option for patients with end-stage CAD [4,5], opponents assert that it is associated with higher mortality and morbidity [6,7].…”

Section: Introductionmentioning

confidence: 99%

Early and mid-term results of coronary endarterectomy: Influence of cardiopulmonary bypass and surgical techniques

et al. 2017

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) on-pump coronary artery bypass with coronary endarterectomy (ONCAB-CE) versus off-pump coronary artery bypass with coronary endarterectomy (OPCAB-CE), and 2) "open" versus "closed" surgical techniques. Operative mortality and major morbidity, were investigated including perioperative myocardial infarction (PMI), and overall survival. Results: Operative mortality was 4.7% (3/64), and no PMI was observed in the study. No statistical differences in operative mortality rate between the ONCAB-CE and OPCAB-CE groups were found (3.1% vs. 6.2%, p = 1.0) or between open versus closed techniques (6.7% vs. 2.9%, p = 0.6). The incidence of major morbidity including cerebrovascular accident, atrial fibrillation, acute renal failure, mediastinitis, respiratory complications, and bleeding was comparable between all groups. There were seven late mortalities, and no differences were found in overall survival rate between all groups. Conclusions: Coronary endarterectomy appears to be a safe option for patients with diffuse coronary artery disease, regardless of whether CPB or a specified selection of surgical techniques are used. (Cardiol J 2017; 24, 3: 242-249)

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“…As in our group, many other authors have also suggested that sequential LITA anastomoses as the best method to revascularize the LAD system which is diseased at multiple segments[1,13]). Although, endarterectomy is another option in such cases, we also believe that sequential LITA grafting to be a less invasive, safe and a more effective procedure in every possible patients, when compared to endarterectomy with its morbidity and mortality rates reaching significant differences in some reports especially when performed on the LAD [4,7,14].…”

Section: Discussionmentioning

confidence: 60%

Long term follow up results of sequential left internal thoracic artery grafts on severe left anterior descending artery disease

Mert

Çetin

Yıldız

et al. 2010

J Cardiothorac Surg

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PurposeSeveral alternative procedures have been proposed to achieve complete revascularization in the presence of diffuse left anterior descending coronary artery (LAD) disease. With the extensive use of internal thoracic artery grafts in coronary artery bypass procedures, sequential anastomosis of the left internal thoracic artery (LITA) to LAD has gained popularity in these challenging cases. The long term results of sequential LITA to LAD anstomosis were examined in this study.Patients and MethodsIn order to determine the long term results of the sequential revascularization of LAD by LITA graft, 41 out of 49 patients operated between January 2001 and December 2005 were selected for control coronary arteriography. The median period for control coronary arteriography was 64 months.ResultsSeventy five anastomoses were found to be fully patent (91,46%) among the 82 sequential LITA anastomoses (41 LITA grafts) on the LAD at a median follow-up period of 64 months (53 to 123 months). Among the 41 LITA grafts used for this purpose, 36 were found intact (complete patency of the proximal and distal anastomoses) (87,8%). Two LITA grafts (4 anastomoses) were found to be totally occluded (4,87%). The proximal anastomosis of the LITA graft was observed to be 90% stenotic in one patient (1,21%). In one patient tight stenosis of the distal anastomosis line was observed (1,21%), while in another patient 70% narrowing of LITA lumen after the proximal anastomosis was detected (1,21%).ConclusionWe strongly beleive that sequential LITA grafting of LAD is a safe alternative in the presence of severe LAD disease to achieve complete revascularization of the anterior myocardium with patency rates not much differing from conventional single LITA to LAD anastomosis.

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Controversial aspects of coronary endarterectomy

Cited by 58 publications

References 12 publications

Myocardial revascularization with coronary endarterectomy. Stratification of risk factors for early mortality

Myocardial revascularization with coronary endarterectomy. Stratification of risk factors for early mortality

Early and mid-term results of coronary endarterectomy: Influence of cardiopulmonary bypass and surgical techniques

Long term follow up results of sequential left internal thoracic artery grafts on severe left anterior descending artery disease

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