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Updated: Aug 10, 2026
Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Aortocoronary bypass made possible by coronary endarterectomy
Insights
Coronary endarterectomy with bypass grafting offers a viable option for severely obstructed arteries, achieving a 57% graft patency rate. This technique demonstrated no increased mortality or morbidity in early follow-up.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Severe coronary artery obstruction poses challenges for standard bypass grafting.
- Manual core endarterectomy is a technique to address complex arterial lesions.
Purpose of the Study:
- To evaluate the efficacy and safety of coronary endarterectomy combined with bypass grafting.
- To assess graft patency and clinical outcomes in patients with severe coronary obstruction.
Main Methods:
- Thirty patients underwent bypass grafting following manual core endarterectomy of coronary arteries.
- Graft patency and perioperative/follow-up outcomes were monitored up to 29 months.
- Routine postoperative anticoagulant therapy was not administered.
Main Results:
- The overall patency rate for bypass grafts to endarterectomized coronary arteries was 57%.
- Patency rates were lower compared to bypass grafts to non-endarterectomized vessels (75-80%).
- No significant increase in perioperative or long-term mortality or morbidity was observed.
Conclusions:
- Coronary endarterectomy with bypass grafting is a valuable alternative when standard bypass grafting is not feasible due to severe obstruction.
- The procedure shows promise, offering a superior option compared to endarterectomy alone.
- Further investigation into optimizing outcomes and anticoagulation strategies is warranted.
Abstract:
Thirty bypass grafts to coronary arteries were made possible by manual core endarterectomy. The overall patency rate of the grafts was 57%, which is less than the patency rate of bypass grafts to nonendarterectomized vessels (75 to 80%). In the perioperative period and during follow-up to 29 months there was no increase in mortality or morbidity even when the endarterectomized vessel subsequently became occluded. These results represent early technical experience. Routine anticoagulant therapy in the postoperative period, to prevent early occlusion, was not used. The results of this and other studies suggest that coronary endarterectomy with bypass grafting is a useful procedure in situations where the coronary artery is so severely obstructed that standard saphenous vein bypass grafting cannot be performed; the procedure is superior to coronary endarterectomy alone.
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