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Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
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Coronary endarterectomy with beating heart in patients with diffuse atheromatous coronary artery disease and poor

Alper Sami Kunt1, Osman Tansel Darcin, Recep Demirbag

  • 1Department of Cardiovascular Surgery, Harran University Research Hospital, Sanliurfa, Turkey. dralper@msn.com

The Heart Surgery Forum
|May 5, 2005
PubMed

Insights

Off-pump coronary artery endarterectomy is a viable option for patients with severely reduced left ventricular function and diffuse coronary artery disease, offering improved midterm survival and graft patency despite increased early risks.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Vascular Surgery

Background:

  • Retrospective review of off-pump coronary artery bypass grafting and endarterectomy.
  • Focus on patients with severely reduced left ventricular function and diffuse coronary artery disease.
  • Evaluation of early and midterm outcomes.

Purpose of the Study:

  • To evaluate the early and midterm results of off-pump coronary artery bypass grafting with coronary artery endarterectomy.
  • To assess the safety and efficacy of this procedure in a high-risk patient population.
  • To determine the impact on left ventricular function and graft patency.

Main Methods:

  • Retrospective analysis of 42 patients undergoing off-pump myocardial revascularization with coronary artery endarterectomy (July 1998 - March 2004).
  • Patient cohort: mean age 59 years, 64.2% with prior myocardial infarction, 26.2% emergency operations, all with ejection fraction <30%.
  • Left anterior descending artery was the most commonly endarterectomized vessel (75%).

Main Results:

  • Early mortality rate was 11% (5 deaths).
  • Midterm outcomes: 67.6% symptom-free, 8 patients in CCS classes II-IV.
  • Improved ejection fraction in 71.42% of patients with follow-up.
  • 28.4-month patency rate for endarterectomized arteries was 89%.

Conclusions:

  • Off-pump coronary artery endarterectomy is associated with increased operative mortality and morbidity.
  • Despite risks, the procedure offers acceptable early and midterm survival, improved clinical status, and sustained graft patency.
  • This technique provides a revascularization option for patients with otherwise inoperable diffuse coronary artery disease and severely depressed left ventricular function.
Abstract

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