[Off-pump coronary artery bypass with endarterectomy]

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Reconstruction

Context:

• Diffuse disease of the left anterior descending (LAD) coronary artery presents significant challenges in treatment.
• Current surgical and interventional approaches have limitations in managing extensive LAD pathology.

Purpose:

• To evaluate the surgical outcomes of off-pump coronary artery reconstruction for diffusely diseased LAD.
• To compare outcomes with and without the addition of endarterectomy.

Summary:

• 118 patients underwent off-pump LAD reconstruction using the left internal thoracic artery (LITA), with or without endarterectomy.
• Operative mortality was 0.8%, with a 14.4% perioperative myocardial infarction rate.
• Early angiographic follow-up demonstrated a 96.2% patency rate for the LITA-to-LAD grafts.

Impact:

• Off-pump coronary artery reconstruction with LITA, including endarterectomy, is a safe and effective option for treating diffusely diseased LAD.
• This surgical strategy achieves favorable early graft patency and acceptable clinical results.