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[Coronary endarterectomy].

K Hirata, T Miyamoto, R Sakata

    [Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
    |March 1, 1989
    PubMed
    Summary
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    Coronary endarterectomy combined with bypass grafting is safe and effective for diffuse coronary artery disease, particularly in the right coronary artery (RCA). While graft patency rates were lower than non-endarterectomy grafts, they were satisfactory, especially for RCA lesions.

    Area of Science:

    • Cardiovascular Surgery
    • Vascular Surgery
    • Interventional Cardiology

    Background:

    • Coronary artery disease (CAD) management often involves coronary artery bypass grafting (CABG).
    • Diffuse CAD may necessitate adjunct procedures like endarterectomy.
    • The efficacy and safety of coronary endarterectomy as an adjunct to CABG require evaluation.

    Purpose of the Study:

    • To assess the safety and efficacy of coronary endarterectomy as an adjunct to CABG.
    • To evaluate graft patency rates in patients undergoing coronary endarterectomy.
    • To compare outcomes between endarterectomy and non-endarterectomy groups.

    Main Methods:

    • Retrospective analysis of 314 patients undergoing CABG between July 1984 and December 1986.
    • 70 patients (22%) required coronary endarterectomy (END group).

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  • Early postoperative angiography (4 weeks) assessed graft patency in 54 patients.

    • Main Results:

    • The overall hospital mortality rate for the END group was 7%; perioperative myocardial infarction occurred in 7% of patients.
    • Patency rates for RCA endarterectomy were 81.8%, and for LCA endarterectomy were 75%.
    • Non-endarterectomy grafts had a patency rate of 86.6%; however, endarterectomy likely improved patency in selected cases, especially for RCA lesions.

    Conclusions:

    • Coronary endarterectomy is a safe and useful adjunct to CABG for diffuse CAD.
    • Outcomes for right coronary artery (RCA) endarterectomy were satisfactory and superior to left coronary artery (LCA) endarterectomy.
    • Coronary endarterectomy is particularly beneficial for managing diffuse disease in the RCA system.