Early Outcomes of Coronary Endarterectomy in Patients Undergoing Coronary Artery Bypass Surgery

2016 ◽  
Vol 19 (2) ◽  
pp. 059
Author(s):  
Amin Bagheri ◽  
Ahmad Masoumi ◽  
Jamshid Bagheri

<strong>Background:</strong> Coronary endarterectomy (CE) is performed as an adjunct to coronary artery bypass surgery (CABG); however, the efficacy of this technique is still controversial. We aimed to evaluate the impact of CE combined with CABG when compared with isolated CABG.<br /><strong>Methods:</strong> Patients who underwent CABG between July 2007 and June 2014 were included. 70 of 2452 patients (2.8%) underwent CE in addition to CABG. Early results were compared with isolated CABG and predictors of adverse outcome were measured in stepwise multivariate logistic regression analyses.<br /><strong>Results:</strong> The incidence of comorbidities including prior myocardial infarction, diabetes mellitus, and three-vessel coronary disease in CE patients was higher; however, mortality (4.3% versus control 3.6%; P = .762) and postoperative complications were not significantly increased in this group of patients (except supraventricular arrhythmia). Although age greater than 70 years, impaired ejection fraction, intraoperative intraaortic balloon pump, and prolonged cardiopulmonary bypass time were important predictors of adverse outcomes, CE was not associated with increased mortality or postoperative morbidities. <br /><strong>Conclusion:</strong> Despite the higher risk profile of patients who underwent CE, this technique was not identified as an independent risk factor for adverse postoperative outcomes.

2009 ◽  
Vol 6 (4) ◽  
pp. 1081-1089 ◽  
Author(s):  
Osama A. Mohamed ◽  
Carol J. Bennett ◽  
Mohamed Farid Roaiah ◽  
Tarek Helmy ◽  
Ali Mahran ◽  
...  

2011 ◽  
Vol 12 (6) ◽  
pp. 993-997 ◽  
Author(s):  
N. Tsirikos Karapanos ◽  
S. H. Suddendorf ◽  
Z. Li ◽  
M. Huebner ◽  
L. D. Joyce ◽  
...  

2007 ◽  
Vol 6 (1) ◽  
pp. 39 ◽  
Author(s):  
Mathijs Vogelzang ◽  
Miriam Hoekstra ◽  
José T Drost ◽  
Marcel Janse ◽  
Iwan CC van der Horst ◽  
...  

Author(s):  
Murtaza Y. Dawood ◽  
Eric J. Lehr ◽  
Andreas de Biasi ◽  
Reyaz Haque ◽  
Alina Grigore ◽  
...  

Robotic assistance has enabled coronary artery bypass surgery to be performed safely in a completely endoscopic fashion, but diffusely diseased target vessels may pose a technical challenge. We present a case in which coronary endarterectomy was performed on the left anterior descending coronary artery during a two-vessel totally endoscopic coronary artery bypass procedure. A 52-year-old woman presented with intermittent substernal pain. Preoperative studies showed diffuse disease in the left coronary artery system. Bilateral internal mammary arteries were harvested robotically using a skeletonized technique in a completely endoscopic fashion. Cardiopulmonary bypass was achieved via peripheral cannulation, and the heart was arrested with intermittent cold antegrade hyperkalemic blood cardioplegia delivered via an ascending aortic occlusion balloon catheter. The first obtuse marginal anastomosis was performed. The left anterior descending coronary artery was diffusely diseased and heavily calcified. An end-to-side anastomosis was attempted to the right internal mammary artery with unsatisfactory results. A localized coronary endarterectomy was performed, and an extended anastomosis was completed using the right internal mammary artery. The patient recovered uneventfully and was discharged home on postoperative day 6. Diffuse coronary artery disease was once thought to be a prohibitive challenge for minimally invasive coronary bypass procedures. This case demonstrates that local coronary endarterectomy is feasible and safe in robotic totally endoscopic coronary artery bypass surgery.


2014 ◽  
Vol 19 (suppl 1) ◽  
pp. S41-S41
Author(s):  
P. E. Antunes ◽  
J. Oliveira ◽  
D. Prieto ◽  
G. F. Coutinho ◽  
P. Correia ◽  
...  

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