Coronary Endarterectomy: An Adjunct to Coronary Artery Bypass Grafting

Ondas ultra-sônicas de alta freqüência causam disfunção endotelial em artérias coronárias caninas epicárdicas

“…Coronary endarterectomy has been used to remove the obstructing plaque in occluded arteries with diffuse disease and enables them to be grafted [1,2,16]. However, endarterectomy is a technically challenging procedure and entails the risks of increased morbidity and mortality [1,3,16].…”

“…Numerous methods have been used to facilitate endarterectomy including specially designed probes, carbon dioxide insufflation which dissects the plaque from the remained. Endareterectomy also entails the risks of increased morbidity and mortality [2,3].…”

Coronary Endarterectomy with Beating Heart in Patients with Diffuse Atheromatous Coronary Artery Disease and Poor Ventricular Function: Early and Midterm Results

“…The best estimate of prevalence has been reported from the Coronary Artery Surgery Study (CASS), in which 4.9% of the patients characterized were said to have had no graftable arteries [CASS 1983]. The currently available therapeutic options for patients with end-stage coronary atherosclerosis include transmyocardial laser revascularization (TMLR) and a CABG procedure combined with CAE [Livesay 1986, Keon 1988, Minale 1989, Eryılmaz 2003, Quigley 2004. Of these options, a few authors have revealed successful results with TMLR [Quigley 2004].…”

“…However, CAE has been reported to be a time-consuming and challenging procedure, and its beneficial effect has been questioned because of an increased risk of perioperative mortality and morbidity, especially when CAE is performed on the LAD [Livesay 1986, Minale 1989]. Lower patency and higher morbidity rates after CAE limit its use to arteries that are inoperable by conventional bypass techniques [Livesay 1986, Brenowitz 1988, Keon 1988, Minale 1989]. We confine this procedure to a small group of patients (2.11%) with severely depressed left ventricular function and diffuse atheromatous coronary artery disease.…”

“…Hospital mortality rates after on-pump CABG with CAE have varied from 4% to 15% and have been reported to be higher than the rates for conventional bypass techniques [Livesay 1986, Brenowitz 1988, Keon 1988. For this reason, we prefer off-pump coronary artery surgery with CAE in patients with diffuse coronary artery disease.…”