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Coronary Endarterectomy: Postoperative Angiographic Results

J Coll Physicians Surg Pak. 2022 Aug;32(8):969-974. doi: 10.29271/jcpsp.2022.08.969.

ABSTRACT

OBJECTIVE: To compare the postoperative graft patency rates of patients who had undergone coronary endarterectomies (CE) during coronary bypass surgery to those of patients who had not had CE, based on postoperative coronary angiography.

STUDY DESIGN: Comparative descriptive study.

PLACE AND DURATION OF STUDY: Coronary Angiography Unit, Tınaztepe University Faculty of Medicine, Turkey, from November 2010 through June 2021.

METHODOLOGY: Patients who had undergone CE during coronary bypass surgery were included. Postoperative morbidity results and the patency rates of the vessels with and without endarterectomy were evaluated via coronary angiographies that had been performed.

RESULTS: The patency rate in vessels that underwent coronary endarterectomy was determined to be 73.4% according to coronary angiographies performed after an average of 47.7 months. The patency rate in vessels without endarterectomy was 63.7%. The highest patency rate was found in the left anterior descending artery (LAD) in both CE and conventional bypass coronary arteries and the lowest patency rate was found in the diagonal artery (D) in both CE and conventional bypass coronary arteries. In the comparison of vessels with and without CE, the patency rate was found to be 66.6% in patients with CE on the right coronary artery (RCA) and 45.7% in patients without CE on the right coronary artery and the difference was statistically significant (p<0.037).

CONCLUSION: Coronary endarterectomy should be used when it is believed that a simple anastomosis would not provide adequate patency during coronary bypass surgery because the primary goal should be to achieve full revascularization and a long-term patency rate.

KEY WORDS: Coronary angiography, Coronary bypass grafting, Endarterectomy, Patency rate.

PMID:35932117 | DOI:10.29271/jcpsp.2022.08.969

By Nevin Manimala

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