Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

Abstract

Background: Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE), it is still used as an adjunct to coronary artery bypass grafting (CABG). This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed.

Comparison of Isolated Coronary Artery Bypass Grafting with Open Coronary Endarterectomy Followed by Coronary Artery Revascularization

“…This result was similar to the result reported in the literature. 1,4,10,11 Additionally, angiographic results were significantly in favor of open endarterectomy in midterm period. 12 After control coronary angiography; stenoses or occlusion free anastomoses have been found 76.1% of patients with long arteriotomy and on-lay patch anastomoses in a mean 20 months whereas 38.1% of the patients with short arteriotomy and closed traction method in a mean 24 months.…”

“…In the literature the early mortality rates after coronary endarterectomy has been reported as 2.8-6%, which is similar to the present study results. [1][2][3][4][5][6][7]9 Open endarterectomy and long-segment anastomosis were preferred in all cases of the Group-1. Use of both close and open endarterectomy technique in the same series successfully has been demonstrated.…”

Coronary Endarterectomy with off Pump Coronary Artery Bypass Surgery- A Review

“…So that, some author used the open technique for coronary endarterectomy, the quality is guaranteed. 17 Nishi et al observe the outcome of both closed and open methods endarterectomy and finds that open method endarterectomy is superior to closed one. 22 Patients who experienced open method endarterectomy had a lower perioperative morbidity and mortality.…”

“…21 But there is a common practice between these two strategies to remove atherosclerotic plaque that is an arteriotomy is the basic principle in both methods. 17 …”

“…1,17 Since then, several study have shown that the complete myocardial revascularization of coronary artery disease by CABG with CE can be done safely and it enhanced the post-operative outcomes by improving myocardial function. [18][19][20] Definition and types of Coronary Endarterectomy Coronary Endarterectomy is a surgical procedure involving the removal of atheromatous plaque, and isolating the outer media and adventitia layers of artery and reestablishing the blood flow to the distal part of to the coronary artery ( Figure-1).…”