Original ArticleOutcome of coronary endarterectomy: a case-control study
Section snippets
The study group
Between January 1993 and August 1996, 1366 patients underwent isolated primary CABG in our institution. Of these, 56 (4.1%) patients required at least one coronary endarterectomy. In view of the previous literature reports, we are conservative about the indications for coronary endarterectomy in our institution. It is only performed on occluded or nearly occluded vessels that have long, multiple stenoses that extend distally. In the absence of widely accepted preoperative criteria, the decision
Results
The number of grafts in the two groups is shown in Table 2. Fifty (89%) patients had one, 4 (7.2%) patients had two, and 2 (3.6%) patients had three coronary arteries endarterectomized. Of these 64 endarterectomies, 33 (51.5%) involved the right coronary artery (RCA), 20 (31.3%) the left anterior descending (LAD) artery, and 11 (17.2%) the major obtuse marginal branch of the circumflex artery.
Comment
The rationale for performing coronary endarterectomy is to undertake as complete a revascularization as possible in coronary arteries with diffuse flow-limiting atherosclerotic stenoses [6]. Early reports of a high incidence of postoperative morbidity and mortality 2, 3, 4, 5 and the introduction of alternative coronary interventional procedures such as angioplasty, stenting, and atherectomy [10] are potential explanations for the fact that endarterectomy is currently performed more
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2014, Journal of CardiologyCitation Excerpt :But is coronary endarterectomy a safe procedure? Overall, hospital mortality rate ranges from 2.0% to 6.5% in international literature [16,19–21,25,29,30,38–40]. However, the mortality after CABG along with endarterectomy appears to be higher compared to that after conventional CABG because of the associated comorbidities and risk factors rather than the endarterectomy itself [1].