Experiences of the Coronary Endarterectomy with Closed Technique in Coronary Artery Bypass Surgery

Abstract

Background Coronary artery bypass grafting (CABG) with coronary artery endarterectomy (CE) is a necessary and effective alternative procedure for complete vascularization in diffuse and severe coronary artery disease. The mid- to long-term outcomes of CE remain highly controversial. The aim of this study is to compare the results of closed-technique CABG CE with those of other recently published articles. Methods In this prospective study, 6000 patients underwent standard coronary artery bypass grafting between August 2004 and August 2014. Approximately 3.2% of these patients, or a total of 193 patients, underwent CE as part of this surgery. A closed-technique was performed in all patients who underwent CE. Results The perioperative myocardial infarction and postoperative morbidity of patients who underwent the closed-technique CE remained unchanged; however, the mortality rate of these patients compared with the open technique CE was lower than that reported in the current literature. In addition, the closed- technique is a highly advantageous technique. It is considered an overall safe procedure because the anastomosis time is short and minimal cross-clamp time when compared with the open technique CE. Conclusion The closed-technique CE should be considered an adequate, safe surgical procedure and a good alternative choice for complete revascularization in suitable patients. Furthermore, the closed-technique CE is a safe operation for the patient with excellent survival rates and graft patency rates. In a select group of patients, perioperative and postoperative mortality and morbidity are not high when the procedure is performed by an experienced team of OR.