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Coronary endarterectomy combined with coronary artery bypass grafting might decrease graft patency: A cohort study

Xieraili Tiemuerniyazi1, Ziang Yang1, Yangwu Song1

  • 1Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Hellenic Journal of Cardiology : HJC = Hellenike Kardiologike Epitheorese
|July 12, 2023
PubMed

Insights

Coronary artery bypass grafting (CABG) plus endarterectomy (CE) may reduce graft patency, particularly in right coronary artery (RCA) procedures. Further research is needed to confirm these findings in larger patient cohorts.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Cardiac Surgery

Background:

  • Graft patency following coronary endarterectomy (CE) combined with coronary artery bypass grafting (CABG) is not well understood.
  • This study investigates graft patency rates in patients undergoing CABG + CE.

Purpose of the Study:

  • To evaluate graft patency after CABG + CE.
  • To identify predictors of graft failure in CE-targeted vessels.

Main Methods:

  • Retrospective analysis of 160 patients undergoing CABG + CE between September 2008 and July 2022.
  • Coronary angiography data used to assess primary endpoint: follow-up graft patency of CE targets.
  • Logistic regression analysis to identify predictors of CE-targeted graft failure.

Main Results:

  • 166 CE procedures performed on LAD, RCA, circumflex, and diagonal branches.
  • Overall CE-targeted graft patency was 69.9% at a median follow-up of 12.1 months.
  • Right coronary artery CE (RCA-CE) was associated with increased graft failure risk (OR 2.35; P=0.028). LAD-CE showed higher patency than non-LAD-CE but lower than non-endarterectomized LAD.

Conclusions:

  • CABG + CE may be linked to reduced graft patency, especially for RCA-CE.
  • Surgical technique (on-pump vs. off-pump) did not significantly impact graft patency.
  • A multi-center prospective study is recommended to validate these findings.
Abstract

Keywords:
coronary artery bypass graftingcoronary endarterectomygraft patency

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