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Related Experiment Videos

Surgical revascularisation for diffuse CAD--an experience in 116 cases.

M C Tong1, C Siva, J Wong

  • 1Department of Cardiothoracic Surgery, Singapore General Hospital.

Annals of the Academy of Medicine, Singapore
|January 1, 1989
PubMed
Summary

Coronary endarterectomy with patch angioplasty effectively treats diffuse coronary artery disease, improving angina and effort tolerance in over 95% of patients. This safe procedure offers an alternative when bypass grafting alone is insufficient.

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Patients with severe triple vessel disease and angina pectoris often present with complex comorbidities.
  • Medical management and traditional bypass grafting may be insufficient for diffuse coronary artery disease.
  • The increasing prevalence of percutaneous coronary interventions and repeat bypass surgeries leads to patients with more advanced disease.

Purpose of the Study:

  • To evaluate the efficacy and safety of coronary endarterectomy with patch angioplasty for diffuse coronary artery disease.
  • To assess clinical outcomes, including angina relief and functional improvement.
  • To determine the long-term effectiveness of this surgical approach.

Main Methods:

  • A cohort of 116 patients (94 male, 22 female) with severe triple vessel disease underwent endarterectomy with patch angioplasty.

Related Experiment Videos

  • Procedures included saphenous vein grafts (86%) and internal mammary artery grafts (12%).
  • Patients were followed up for a mean of 18 months (range 10-43 months).

    • Main Results:

    • No operative mortality was observed.
    • Perioperative infarct rate was 2.7%.
    • Over 95% of patients were clinically free from angina pectoris with improved effort tolerance post-surgery.

    Conclusions:

    • Coronary endarterectomy with patch angioplasty is an effective and safe treatment for diffuse coronary artery disease.
    • This technique provides a valuable option for patients unsuitable for bypass grafting alone.
    • The incidence of diffuse coronary artery disease is expected to rise, highlighting the importance of such surgical interventions.