Coronary Endarterectomy: Recent Trends

Ghatanatti, Ravi

doi:10.7860/jcdr/2017/27036.10339

Cited by 13 publications

(16 citation statements)

References 29 publications

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“…22 However, Ghatanatti and Teli performed a meta-analysis involving a total of 43 recently published (year 2000-2015) research articles and observed that the present available evidence supports CE in off-pump CABG in diffuse coronary artery disease. 23 Long term graft patency rate was better with open endarterectomy technique, however the survival curve remains static at 5-year follow up for both open and closed technique endarterectomy. Furthermore, Ghatanatti and Teli also observed that multi-vessel CE increases the overall incidence of morbidity as well as mortality, and total arterial CABG procedure is associated with better long term survival in high risk population which is concordance with this current study results.…”

Section: Discussionmentioning

confidence: 85%

“…Furthermore, Ghatanatti and Teli also observed that multi-vessel CE increases the overall incidence of morbidity as well as mortality, and total arterial CABG procedure is associated with better long term survival in high risk population which is concordance with this current study results. 23 In another recent study by Qiu et al also observed that in diffuse coronary disease, CE is a safe and feasible procedure for a select group of patients with excellent mid-term survival rates as well as graft patency rates. 24 CE provides better overall outcomes when performed on the LAD artery, and grafted over with the LIMA conduit.…”

Section: Discussionmentioning

confidence: 93%

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Outcome of Coronary Artery Bypass Graft Surgery with Coronary Endarterectomy

Ranjan

Adhikary

2019

Bangladesh Med Res Counc Bull

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Background: Coronary Endarterectomy (CE) is the expulsion of the atheromatous plaque, and isolating the outer media and adventitia layers of arterial wall. Objective of this study was to review the consequences of coronary endarterectomy (CE) with coronary artery bypass grafting (CABG), and demonstrate the outcomes of this surgical technique for patients with diffuse coronary artery disease in a single surgeon’s practice. Methods: Retrospectively outcome of 1473 endarterectomised coronary artery in 1189 patients with diffuse coronary artery disease (CAD) was reviewed, who have had experienced CE with OPCABG in the year of 2007 to 2016. CE was performed in multi-segmental diffuse CAD, or when a calcified or extremely thick plaque making anastomosis troublesome. Results: Approximately 75.0% coronary endarterectomy were performed in the left coronary territory and most commonly left anterior descending artery was endarterectomized (42.83%). An average of 1.2 coronary endarterectomies performed per patient. Post-operative ICU and 30-days mortality rate was 2.2%, and 0.6% respectively in CE group. Post-operative atrial fibrillation, acute MI, neurological complication, and blood transfusion were significantly higher in CE group. Following CE, Kaplan–Meier cumulative survival rate was 89.5%, and about 85% patients were free from angina at follow-up of 5 years. Conclusion: Coronary endarterectomy with OPCABG is attainable, and accomplishes surgical revascularization in patients; when there is no other alternative for total myocardial revascularization. Bangladesh Med Res Counc Bull 2018; 44: 124-131

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 93%

Outcome of Coronary Artery Bypass Graft Surgery with Coronary Endarterectomy

Ranjan

Adhikary

2019

Bangladesh Med Res Counc Bull

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“…In the 1990s, this method was not recommended in routine practice because of high mortality and morbidity rates [4]. When we look at the literature, the rate of coronary endarterectomy application varies between 0.8 and 25% [5].…”

Section: Hap3#2au`$ A#)a$ __ 4'22$ E?@a2#and$ A$ A#)a$ ___ =?@Uhfp'(#$ mentioning

confidence: 99%

Effects of coronary endarterectomy on postoperative early results in long segment coronary artery disease

Güvenç¹,

Goncu

Engin

et al. 2020

The European Research Journal

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Objectives: Main goal of coronary bypass surgery is complete revascularization. In some coronary endarterectomy applied patient groups, complete revascularization is inevitable. In this study, it was aimed to reveal factors affecting early mortality and morbidity in patients undergoing coronary endarterectomy. Methods: Retrospective records of preoperative, operative, and postoperative data of 98 patients undergoing coronary artery bypass grafting (CABG) with coronary endarterectomy between January 1, 2012, and October 30, 2016, were reviewed. Results: A total of 113 endarterectomies were performed in different coronary arteries. Of the patients, 22 (22.4%) were female and 76 (77.6%) were male. The mean of ages was 60.4 ± 9.9 (range; 36-81 years). A positive inotropic requirement was required in 68 (69.1%) patients and intra-aortic balloon pump was required for 23 (23.4%) patients. Mortality was observed in 10 patients (10.2%). Peroperative myocardial infarction was observed in 17 (17.3%) patients. Mortality rate was significantly higher in patients whose left ventricular ejection fraction was 30 or less and who had a higher risk in EuroSCORE (p < 0.001). When compared with the other vessels, mortality ratewas found to be higher for left anterior descending coronary artery endarterectomy (p = 0.038). Mortality in female patients undergoing endarterectomy was higher than male patients (p = 0.023). Conclusions: Mortality and morbidity are higher in patients undergoing coronary endarterectomy when compared to conventional CABG operations. However, it is a method that can be applied by considering certain risk factors.

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“…При закрытой методике удаление атеросклеротической бляшки происходит через относительно небольшой разрез, при этом существует риск неполного удаления бляшки как из основного ствола, так и его ветвей. Техника открытой КЭ подразумевает артериотомию над пораженным участком стенки сосуда на всем протяжении и удаление бляшки под полным визуальным контролем, но данная методика требует больше времени по сравнению с закрытой [16,17]. Открытая методика КЭ часто сочетается с ШП.…”

Section: Discussionunclassified

“…В исследованиях разных авторов летальность после АКШ+КЭ может достигать 15% [16,17,22]. M. Nemati и соавт.…”

Section: таблица 5 частота улучшения локальной сократимости лж послеunclassified

Coronary endarterectomy and shunt plasty in coronary artery bypass surgery: is there any difference in short-term results?

Charchyan¹,

Gerasimov²,

Скворцов³

et al. 2018

Kardiol. serdechno-sosud. khir.

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1 ФГБНУ «Российский научный центр хирургии им. акад. Б.В. Петровского», Москва, Россия 2 кафедра медицинской информатики и статистики Первого МГМУ им. И.М. Сеченова, Минздрава России, Москва, Россия Цель исследования -проанализировать результаты коронарной эндартерэктомии (КЭ) и шунт-пластики (ШП) у больных пожилого и старческого возраста с ИБС и диффузно-дистальным поражением коронарных артерий. Материал и методы. С февраля 2013 г. по декабрь 2016 г. в отделении хирургии аорты и ее ветвей ФГБНУ «РНЦХ им. акад. Б.В. Петровского» аортокоронарное шунтирование (АКШ) в сочетании с КЭ было выполнено 42 больным (1-я группа). 2-я группа включала 42 больных после АКШ с ШП. Контрольная группа включала 42 случайно выбранных пациента после АКШ без применения описанных выше методик. Результаты. Стенокардия III-IV ФК по NYHA и инфаркт миокарда (ИМ) в анамнезе достоверно чаще встречались в группе АКШ+ШП (73,8 и 76,2% соответственно). В бассейне передней межжелудочковой артерии ШП выполнялась в 3,7 раза чаще по сравнению с КЭ (ОР 3,7; 95% ДИ 1,3-10,1; p=0,001). Улучшение локальной сократимости ЛЖ в послеоперационном периоде наиболее чаще встречалось у больных 2-й группы (ОР 26,2%, 95% ДИ 15,7-39,5; p=0,001). По длительности госпитализации группы статистически значимо не различались между собой. Заключение. КЭ и ШП являются сравнимыми техниками в арсенале хирурга. Применение данных методов у больных с диффузно-дистальным поражением коронарного русла позволяет выполнить полную реваскуляризацию миокарда с удовлетворительным ближайшим послеоперационным результатом. Важное значение имеют выполнение процедуры по строгим показаниям, опыт хирурга и тщательное соблюдение протокола послеоперационного ведения больных.Ключевые слова: коронарная эндартерэктомия, шунт-пластика, аортокоронарное шунтирование.

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Coronary Endarterectomy: Recent Trends

Cited by 13 publications

References 29 publications

Outcome of Coronary Artery Bypass Graft Surgery with Coronary Endarterectomy

Outcome of Coronary Artery Bypass Graft Surgery with Coronary Endarterectomy

Effects of coronary endarterectomy on postoperative early results in long segment coronary artery disease

Coronary endarterectomy and shunt plasty in coronary artery bypass surgery: is there any difference in short-term results?

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