Coronary artery endarterectomy during coronary artery bypass grafting - A solution for complete revascularization

Abstract

Background: Performance of CABG with concomitant coronary artery endarterectomy in patients with severe coronary disease provides more complete revascularization. We examined the technique and early outcomes of CABG with endarterectomy (CE). Subjects and method: 24 patients (20 males, 4 females) with severe coronary disease undergoing CABG operations with concomitant coronary artery endarterectomy. They were in a selected cohort with minimum of three grafts for three main vesseles. All patients were operated on by the same group of surgeon. Results: Mean age was 63,8 years. Number of grafts: 4,3 ± 0,7 vessels per patient. CE was performed on right coronary artery 45,8%, on left anterior descending artery 29,1%, circumflex artery 16,6% and diagonal artery 29,1%. Cross-clamp times 147,2 ± 26,0 minutes, perfusion times 180,9 ± 28,2 minutes, ventilated time: 18,9 ± 10,5 hours, ICU stays: 4,8 ± 0,9 days. Operative mortality: 2 patients (8,3%), no technical complication. Conclusion: Coronary endarterectomy should be considered an acceptable adjunct to CABG for patients with extensive coronary artery disease to achieve complete revascularization.