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

Abstract

) 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)

Elective lung resection increases spatial QRS-T angle and QTc interval

“…A 6.4% incidence of postoperative AF was lower than that in other reports [1][2][3][4][5][6]. A significantly wider spQRS-T angle was noted in all of these patients.…”

“…Cardiac arrhythmias, including atrial fibrillation (AF), have been recognized as frequent complications after thoracic surgery [1][2][3][4]. Different kinds of cardiac arrhythmias have been noted in one-fifth of patients after lung resection, AF being the most common [4,5].…”

Coronary endarterectomy and shunt plasty in coronary artery bypass surgery: is there any difference in short-term results?

“…При закрытой методике удаление атеросклеротической бляшки происходит через относительно небольшой разрез, при этом существует риск неполного удаления бляшки как из основного ствола, так и его ветвей. Техника открытой КЭ подразумевает артериотомию над пораженным участком стенки сосуда на всем протяжении и удаление бляшки под полным визуальным контролем, но данная методика требует больше времени по сравнению с закрытой [16,17]. Открытая методика КЭ часто сочетается с ШП.…”

“…В большинстве последних исследований авторы не отмечают достоверной разницы в выполнении АКШ+КЭ с ИК и на работающем сердце [16,22,23]. По данным Q. Zhibing и соавт.…”

“…В исследованиях разных авторов летальность после АКШ+КЭ может достигать 15% [16,17,22]. M. Nemati и соавт.…”