[Surgical treatment of diffuse coronary disease]

In order to obtain an idea on contemporary opportunities of surgical treatment of diffuse coronary disease the authors compared the results of surgery in 103 patients whose finding called for endarterectomy and bridging of at least one coronary artery (KEA) with the results in 220 patients where it was possible to overcome all significant changes by coronary bypasses only (KBP). Patients in group KEA had more infarctions before operation than patients in group KBP. Diffuse changes of the coronary arteries were found only in patients in group KEA. All patients were operated with extracorporeal circulation and local cooling of the myocardium. Surgery took longer in patients of group KEA than in group KBP. Early mortality was higher in group KEA--4.8% than in group KBP--0.9%. This difference was not statistically significant. Early morbidity in group KEA did not differ, from the morbidity in group KBP. Using effective peroperative protection of the myocardium by local cooling, the risk of KEA is only insignificantly higher than the risk of KBP. KEA makes safe and effective revascularization of the heart muscle in patients with diffuse coronary disease possible.