Coronary Endarterectomy: a Case Control Study and Evaluation of Early Patency Rate of Endarterectomized Arteries

Costa, Mário Augusto Cray da; Betero, André Luis; Okamoto, Jefferson Matsuiti; Schafranski, Marcelo Derbli; Reis, Elise Souza dos Santos; Gomes, Ricardo Zanetti

doi:10.21470/1678-9741-2018-0402

Cited by 6 publications

(9 citation statements)

References 18 publications

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“…Therefore, a total of 12 studies including 114,319 patients undergoing CABG were included in our study. [7][8][9][10][11][12][13][14][15][16][17][18] All studies were observational epidemiological studies, 2 of the 12 included studies were multicenter studies, 9,18 and three of the included studies used propensity score matching method. 12,15,18 Of these, 12 provided data for 30days mortality; 11 [7][8][9][10][11][12][13][14][16][17][18] investigated the incidence of postoperative myocardial infraction; 8 7,8,[10][11][12][13][14]17 reported the rate of low output syndrome; 8 [7][8][9][10][11][12][13][14] reported the incidence of cardiac arrhythmia; 5 8,9,12,…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…7–18 All studies were observational epidemiological studies, 2 of the 12 included studies were multicenter studies, 9,18 and three of the included studies used propensity score matching method. 12,15,18 Of these, 12 provided data for 30-days mortality; 11 7–14,16–18 investigated the incidence of postoperative myocardial infraction; 8 7,8,10–14,17 reported the rate of low output syndrome; 8 7–14 reported the incidence of cardiac arrhythmia; 5 8,9,12,17,18 provided the data for renal dysfunction; and 5 7,8,11,14,15 reported 5 years survival. Most of the patients received dual antiplatelet therapy or anticoagulation combined with antiplatelet therapy.…”

Section: Resultsmentioning

confidence: 99%

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Outcomes of coronary artery bypass grafting with coronary endarterectomy: A systematic review and meta-analysis of recent studies

Zhang

2022

Perfusion

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Objective: The aim of this systematic review and meta-analysis was to evaluate the short-term and long-term outcomes of coronary artery bypass grafting (CABG) with coronary endarterectomy (CE) versus isolated CABG. Methods: Studies evaluating outcomes of CABG with CE (CE-CABG) were searched from 1 January 2000 to 30 September 2022, on PubMed, Embase, and Cochrane databases. The primary outcome was 30 -days mortality. Secondary outcomes were postoperative myocardial infraction, low output syndrome, cardiac arrhythmia, renal dysfunction, and 5 years survival. Results: A total of 12 observational studies including 114,319 patients assessing CE-CABG ( n = 35,174) versus isolated CABG ( n = 79,145) were included. Compared to isolated CABG alone, CE-CABG was significantly associated with increased incidences of 30-days mortality (RR, 1.87; 95% CI, 1.73–2.07; p < 0.01), postoperative myocardial infraction (RR, 1.61; 95% CI, 1.26–2.05; p < 0.01), low output syndrome (RR, 1.54; 95% CI, 1.17–2.02; p < 0.01), and renal dysfunction (RR, 1.56; 95% CI, 1.44–1.69; p < 0.01). However, there was no difference in either rate of cardiac arrhythmia (RR, 1.06; 95% CI, 0.97–1.15; p = 0.20) or 5 years survival (RR, 1.05; 95% CI, 0.95–1.16; p = 0.34) between the CE-CABG group and the control group. Subgroup analysis on CE technique showed that CE-CABG was also associated with 30 days mortality in patients undergoing closed CE (RR, 1.49; 95% CI, 1.09–2.03), whereas this association between CE and 30 days mortality was not observed in patients undergoing open CE (RR, 1.76; 95% CI, 0.58–5.32). Conclusions: Despite poor short-term outcomes, CE-CABG appeared to offer satisfactory long-term survival in patients with diffuse coronary artery disease.

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Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Outcomes of coronary artery bypass grafting with coronary endarterectomy: A systematic review and meta-analysis of recent studies

Zhang

2022

Perfusion

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“…Однако их отдаленные результаты либо не проанализированы, либо ограничены крайне небольшим количеством наблюдений -не более 100 пациентов. Ангиографический контроль представлен только в единичных публикациях [6,11,12,28]. В нашем исследовании отслежены отдаленные результаты значительно большего количества больных -558 человек, что в несколько раз превышает объемы выборок в подобных работах.…”

Section: Discussionunclassified

Long-term outcomes of reconstructive procedures on coronary arteries for diffuse coronary atherosclerosis without endarterectomy

Белаш

Shevchenko²,

Ясакова³

et al. 2020

Innovacionnaâ medicina Kubani

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Objective. This study evaluated the long-term clinical and angiographic outcomes of coronary artery reconstruction for a diffusely diseased coronary artery without endarterectomy.Material and Methods. We retrospectively reviewed 660 consecutive patients (mostly men (89.5%), mean age 68.3 ± 7.4 years) who underwent coronary artery bypass grafting in combination with coronary artery reconstruction between 2003 and 2016. 558 operated on patients (84.5%) were followed up for a mean of 94.3 ± 31.2 months.Results. Long-term survival was 83.2% (95% confidence interval: 74.5–89.3); freedom from cardiac death was 97.4 ± 1.2%; and freedom from major adverse cardiac and cerebrovascular events was 64.7 ± 4.1%. Independent predictors of long-term mortality were age at surgery (< 70 years, p < 0.001), chronic obstructive pulmonary disease (p = 0.007), peripheral arterial disease (p = 0.002), diabetes mellitus (p = 0.013) and chronic kidney disease (p = 0.034). The arterial graft patency rate was 95.2%, and the vein graft patency rate was 75.4%.Conclusion. Coronary artery bypass grafting in conjunction with coronary artery reconstruction without endarterectomy confers satisfactory long-term clinical outcomes with high probability of freedom from cardiac death and angina pectoris, good rates of angiographic patency of arterial grafts and favorable rates of vein graft patency.

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“…[1,2] Bazen yaygın ateroskleroz nedeniyle koroner arterlerde uzun segment oklüzyon veya çok ince lümen mevcudiyeti durumlarında tam revaskülarizasyon sağlayabilmek veya anastomozun kalitesini arttırabilmek için koroner endarterektominin (KE) gerekli olabildiği ifade edilmektedir. [3,4] İlk kez 1950'lerde şiddetli ateroskleroz ve miyokardial iskeminin bir tedavisi olarak uygulandığı ifade edilen KE ile ilgili ilk çalışmalarda yüksek mortalite ve morbidite oranlarının yanı sıra KE'nin postoperatif akut miyokard enfarktüsü (MI) ile ilişkili olduğunun ve bu nedenlerle pek tercih edilmediğinin bildirildiği de ifade edilmektedir. [3,5] Literatürde KE ile kombine KABG'de riskin KE uygulanmaksızın gerçekleştirilen KABG'den daha yüksek olduğunun bildirilmesine rağmen, koroner arter cerrahi revaskülarizasyonu gerektiren hasta grubunda diffüz veya kompleks lezyon insidansının artması nedeniyle tam revaskülarizasyon sağlayabilmek amacıyla KE uygulanabileceği ve ayrıca, cerrahi teknikteki ve perioperatif yönetimdeki ilerlemelerle KE sonuçlarının eskiye oranla daha iyi olduğu bildirilmektedir.…”

Section: Introductionunclassified

Koroner Endarterektomi ile kombine Koroner Arter Baypas Greftleme: Tek Merkez Deneyimi

Yılmaz

Günaydın

2023

Turkish Journal of Clinics and Laboratory

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Amaç: Koroner arterlerde yaygın ateroskleroz nedeniyle uzun segmen toklüzyon veya çok ince lümen mevcudiyeti durumlarında revaskülarizasyon sağlayabilmek veya anastomozun kalitesini arttırabilmek için koroner arter endarterektomisi gerekli olabildiği bildirilmektedir. Koroner endarterektomi ile kombine koroner arter baypas greftlemede riskin sadece koroner arter bypass greftleme gerçekleştirilen hastalardan daha yüksek olduğunun bildirilmesine rağmen, revaskülarizasyon gerektiren hasta grubunda diffüz veya kompleks koroner kalp hastalığı insidansının artması nedeniyle tam revaskülarizasyon sağlayabilmek amacıyla endarterektomi uygulanabileceği ve cerrahi teknikteki ve perioperatif yönetimdeki ilerlemelerle sonuçların eskiye oranla daha iyi olduğu ifade edilmektedir. Yöntem: Retrospektif çalışmamız koroner arter baypas greftleme operasyonu uygulanmış hastalarda gerçekleştirildi. Çalışmaya ilk defa elektif izole koroner arter baypas greftleme operasyonu uygulanan (koroner endarterektomi ile kombine veya değil) hastalar dahil edildiler. Koroner arter baypas greftleme operasyonu ile eşzamanlı farklı bir kardiyak, karotis veya aort cerrahisi uygulanan hastalar, farklı bir açık kalp operasyonu uygulanan hastalar, ikinci defa açık kalp ameliyatı uygulanan hastalar çalışmaya dahil edilmediler. Bulgular: Çalışmaya dahil edilen toplam 184 hastanın (142 tanesi erkek) yaş ortalaması 63.5+/-9.58 idi. Hastalardan 10 tanesine koroner arter endarterektomisi ile kombine koroner arter baypas greftleme operasyonu gerçekleştirilmişti. Sol ön inen arter ve Diagonal artere (koroner endarterektomi hastalarının %50’si) uygulanan endarterektomiler açık teknikle gerçekleştirilmişti. Koroner endarterektomi uygulananlardan 2 tanesinde erken dönem mortalite gözlendi. Sonuç: Hedef koroner arterlerde özellikle uzun segment ciddi stenoz/oklüzyon varlığı gibi anastomoz kalitesini azaltan ve anastomozu zorlaştıran durumlarda koroner endarterektomi ile kombine koroner arter baypas greftleme yönteminin özellikle cerrahi tecrübe ve uygun hasta seçimi varlığında güvenli ve sonuçlarının kabul edilebilir olabileceğini düşünmekle birlikte daha fazla hasta sayılı çalışmaların yapılmasının yararlı olabileceğini düşünmekteyiz.

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Coronary Endarterectomy: a Case Control Study and Evaluation of Early Patency Rate of Endarterectomized Arteries

Cited by 6 publications

References 18 publications

Outcomes of coronary artery bypass grafting with coronary endarterectomy: A systematic review and meta-analysis of recent studies

Outcomes of coronary artery bypass grafting with coronary endarterectomy: A systematic review and meta-analysis of recent studies

Long-term outcomes of reconstructive procedures on coronary arteries for diffuse coronary atherosclerosis without endarterectomy

Koroner Endarterektomi ile kombine Koroner Arter Baypas Greftleme: Tek Merkez Deneyimi

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