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[Coronary endarterectomy associated with by-pass. A series of 111 patients controlled angiographically]
Insights
Coronary endarterectomy combined with bypass surgery had a 72% patency rate, which is satisfactory given the necessity of the procedure. This outcome is comparable to other reported series.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Coronary bypass surgery is a common procedure for coronary artery disease.
- Coronary endarterectomy is sometimes performed concurrently with bypass surgery.
- Patient selection and outcomes for combined procedures require evaluation.
Purpose of the Study:
- To evaluate the outcomes of coronary endarterectomy performed alongside coronary bypass surgery.
- To assess the patency rates and clinical results of combined procedures.
Main Methods:
- Retrospective analysis of 111 patients who underwent combined coronary bypass surgery and endarterectomy.
- Review of control angiographies performed post-surgery.
- Assessment of vessel patency, hospital mortality, and postoperative myocardial infarction rates.
Main Results:
- The overall hospital mortality was 6%, higher than bypass surgery alone.
- Postoperative myocardial infarction rate was 10%.
- The endarterectomized vessel patency rate was 72%, lower than bypass graft patency.
Conclusions:
- Coronary endarterectomy combined with bypass surgery yields satisfactory results when indicated by necessity.
- The patency rate of endarterectomized vessels is lower than bypass grafts but acceptable.
- Further comparison with other series confirms the viability of this combined approach.
Abstract:
Out of 2 638 patients undergoing coronary bypass surgery at the Arnault Tzanck Centre from 1973 to September 1984, 305 (12%) also required coronary endarterectomy. One hundred and eleven of these patients had control angiographies at the Centre and were the object of this study. Endarterectomy was carried out on a totally occluded artery in 38% of cases and was performed out of necessity in the other cases. One hundred and twenty-nine disobliterations were performed in these 111 patients. The average number of bypass grafts per patient was 2.8. The overall hospital mortality was 6% (19 out of 305) which was higher than for bypass surgery alone. The postoperative myocardial infarction rate was 10%. The 117 control angiographies were performed on average during the 8th month after surgery; these controls were routine in 99 cases (84.5%) in Stage I of the NYHA classification and for recurrent angina in 18 cases (15.5%). The endarterectomised vessel was patent in 72% of cases, which was less than the patency rate of the bypass grafts. Considering the indications of necessity, this result is satisfactory and is compared which those of other reported series.