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Results of adjunctive coronary endarterectomy in 548 patients

Serdar Akgun1, C Selim Isbir, Tekin Yildirim

  • 1Department of Cardiovascular Surgery, Medicana Bahcelievler Hospital, Istanbul, Turkey.

The Heart Surgery Forum
|April 24, 2008
PubMed

Insights

Coronary endarterectomy as an adjunct to bypass grafting had a 6.2% mortality rate. This procedure is a last resort for diffuse coronary artery disease due to higher risks than standard bypass surgery.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary endarterectomy is a debated surgical option for coronary artery disease.
  • It is sometimes used as an additional therapy during coronary artery bypass graft (CABG) surgery.

Purpose of the Study:

  • To evaluate the short-term outcomes of coronary endarterectomy performed as adjunctive therapy for CABG.
  • To identify risk factors associated with adverse outcomes in patients undergoing this procedure.

Main Methods:

  • Retrospective analysis of 548 patients who underwent adjunctive coronary endarterectomy between 1996 and 2004.
  • Assessment of short-term postoperative outcomes and mortality.
  • Identification of predictors for early mortality.

Main Results:

  • The mean patient age was 67.9 years, with a mean angina class of 2.7.
  • Postoperative mortality was 6.2% (34 patients).
  • Recent myocardial infarction and left ventricular dysfunction were predictors of early mortality.

Conclusions:

  • Adjunctive coronary endarterectomy can yield acceptable results but carries a higher mortality rate than standard CABG.
  • This procedure should be reserved as a final surgical option for diffuse coronary artery disease.

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