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Manual coronary endarterectomy. Clinical experience in 315 patients
Insights
Manual endarterectomy of coronary arteries is a safe procedure, showing a 76.3% patency rate. This surgical technique can be a valuable addition to coronary artery bypass grafting when applied selectively.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Coronary artery disease necessitates surgical intervention.
- Coronary artery bypass grafting (CABG) is a common treatment.
- Endarterectomy offers an alternative or adjunct for specific coronary lesions.
Purpose of the Study:
- To evaluate the safety and efficacy of manual endarterectomy.
- To determine the patency rates and outcomes of coronary endarterectomy.
- To assess the role of endarterectomy as an adjunct to CABG.
Main Methods:
- Manual endarterectomies performed on 330 coronary arteries in 315 patients between July 1970 and December 1973.
- Procedures included both elective and nonelective cases.
- Postoperative catheterization assessed patency at an average of 13.1 months.
Main Results:
- Overall hospital mortality rate was 1.27%.
- Postoperative myocardial infarction occurred in 4.8% of patients.
- The overall patency rate for endarterectomized arteries was 76.3%.
Conclusions:
- Manual endarterectomy is a safe procedure for selected coronary arteries.
- Endarterectomy demonstrates a significant patency rate, suggesting long-term viability.
- The technique is a useful adjunct to saphenous vein bypass grafting when used judiciously.
Abstract:
From July, 1970, to December, 1973, manual endarterectomies were performed on 330 coronary arteries in 315 patients. The procedures were performed on either an elective or nonelective basis. The over-all hospital mortality rate was 1.27 per cent. Postoperative myocardial infarction occurred in 4.8 per cent of these patients. Postoperative catheterization was performed on 186 endarterectomized arteries; the average time of postoperative catheterization was 13.1 months after surgery. The over-all patency rate was 76.3 per cent. This experience suggests that endarterectomy is a safe and useful adjunct to saphenous vein bypass grafting procedures when used in a restricted fashion as detailed in this presentation.