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Coronary Endarterectomy: a Case Control Study and Evaluation of Early Patency Rate of Endarterectomized Arteries

Mario Augusto Cray da Costa1,2, André Luís Betero3, Jefferson Okamoto3

  • 1Universidade Estadual de Ponta Grossa Department of Medicine Ponta Grossa Paraná Brazil Department of Medicine, Universidade Estadual de Ponta Grossa - Campus Uvaranas, Ponta Grossa, Paraná, Brazil.

Brazilian Journal of Cardiovascular Surgery
|April 10, 2020
PubMed

Insights

Coronary endarterectomy (CE) during coronary artery bypass grafting (CABG) shows similar graft patency, morbidity, and mortality rates compared to standard CABG. This procedure offers comparable outcomes despite longer procedure times.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Graft Patency

Background:

  • Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
  • Coronary endarterectomy (CE) is a complementary procedure sometimes performed with CABG.
  • The comparative outcomes of CABG with CE versus CABG alone require further investigation.

Purpose of the Study:

  • To compare major and minor outcomes between patients undergoing CABG with CE and those undergoing CABG without CE.
  • To evaluate early graft patency rates in patients who had CE.
  • To assess the safety and efficacy of CE as an adjunct to CABG.

Main Methods:

  • Retrospective review of a patient database from January 2011 to June 2017.
  • Comparison of 25 patients who underwent CABG with CE against 201 patients who underwent CABG alone.
  • Analysis of perioperative outcomes including myocardial infarction, stroke, mortality, cardiopulmonary bypass time, aortic clamp time, and hospital stay.

Main Results:

  • No significant differences were observed in post-surgical hospitalization, perioperative myocardial infarction, stroke, or mortality rates.
  • Coronary endarterectomy was associated with significantly longer aortic clamping and cardiopulmonary bypass times.
  • Early graft patency in the CE group was 78.95%, consistent with existing literature.

Conclusions:

  • Coronary endarterectomy, when performed with CABG, demonstrates early graft patency rates comparable to literature values.
  • The addition of CE to CABG did not result in statistically significant differences in major adverse outcomes (morbidity and mortality) in this patient cohort.
  • CE can be considered a viable option in selected cases, offering similar clinical outcomes to conventional CABG.
Abstract

Keywords:
Cardiopulmonary BypassCoronary Artery BypassEndarterectomyLength of StayMorbityMyocardial InfarctationStroke

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