Early and mid-term results of off-pump endarterectomy of the left anterior descending artery

Abstract

We conclude that off-pump endarterectomy of the LAD is a viable option for patients with diffuse LAD disease.

A Single Centre Experience With Coronary Endarterectomy in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting

“…The reported incidence of early mortality after CCE is between 1% and 15% 7,10,11,17,20,23,24,25,26,27 and is higher than that of patients undergoing CABG without CE in the same institutions. OPCAB-CE was associated with a low perioperative mortality ranging from zero in smaller case series to 2.8% in the largest study.…”

Coronary Endarterectomy with off Pump Coronary Artery Bypass Surgery- A Review

“…Postoperative mean follow-up period was 24 ± 19 months; revealed neither early nor midterm myocardial ischemia. 23 Naseri et al likewise demonstrated that the intubation time, ICU stay, and the length of hospitalization was not exactly same between on pump CABG with coronary endarterectomy (CE) and after OPCABG with CE. 20 Besides, in spite of the fact that the duration of ventilation was comparative in our review and that of Eryilmaz et al the length of hospitalization was higher in the last arrangement.…”

“…22,23 However, a longitudinally opened saphenous vein can be used to repair the arteriotomy and thereafter the left internal mammary artery can be anastomosed with the vein patch. 5 Note that, this open method is time consuming but the atheromatous plaque is extracted under direct vision, so the openings of the distal end of the LAD and side branches can be checked directly.…”

“…2 In the close method, coronary endarterectomies were performed manually by slow sustain and continuous traction of atheroma trailed by reproduction with anastomosis with pre-planned graft. 2,23 Two synchronous arteriotomy can be used for coronary endarterectomy to make the framework rapid and reduce ischemic time. 24 The close method is shorter in duration and the graft anastomosis is easier than open method.…”

“…5 So that, after coronary endarterectomy, routine Heparin infusion is prescribed to prevent thrombosis in graft or native tissue in the early post-operative period followed by oral warfarin for next 6 months. 10,23 Perhaps, combination of antiplatelet and anticoagulation is also required 2 . Till date, there is no standard anticoagulation regimen after coronary endarterectomy exists.…”