Hospital Outcome of Coronary Artery Bypass Grafting and Coronary Endarterectomy

Abid, Abdul Rehman; Farogh, Ajwad; Naqshband, Mumraiz Salik; Akhtar, Raja Parvez; Khan, Jawad

doi:10.1177/0218492309102609

Cited by 10 publications

(4 citation statements)

References 15 publications

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“…Based on these results, most authors have concluded that CE is a suitable method in the treatment of severely diseased coronary arteries for which complete revascularization cannot be obtained otherwise [ 2 – 12 ]. Prospective randomized trials can provide an accurate and unbiased comparison of outcomes; however, the only well-designed prospective randomized trial so far published comparing CABG with or without CE had a sample size of 50 for each group [ 13 ]. The low sample size of this study resulted in a low statistical power, and therefore the study could not show a difference between either the short-term or long-term outcomes associated with CE and CABG [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Outcome and Graft Patency in Coronary Artery Bypass Grafting with Coronary Endarterectomy

Nemati

Astaneh

Khosropanah

2015

Korean J Thorac Cardiovasc Surg

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BackgroundControversy persists regarding the use of coronary endarterectomy (CE) in patients with severe coronary artery disease. We compared the comorbidities and perioperative characteristics of patients undergoing coronary artery bypass grafting (CABG) with and without CE.MethodsThis study was performed in two private hospitals in Shiraz, Iran from May 2010 to December 2011 on 967 patients who underwent CABG without CE and 84 patients who underwent CABG with CE (the CE+ group). After follow-up at 9.66±3.65 months post-surgery, 28 patients from the CE+ group underwent angiography to evaluate the patency of grafts and native coronary vessels.ResultsPatients in the CE+ group had a more prevalent history of diabetes (48% vs. 36%) and number of diseased vessels (2.88±0.39 vs. 2.70±0.85). The overall hospital mortality was 1.8%, and no significant difference was observed between the two groups. In the 28 patients who underwent reangiography, 113 vessels were bypassed and 29 endarterectomies were performed, mostly on the left anterior descending artery (12 endarterectomies) and the right coronary artery (8 endarterectomies). In the endarterectomized vessels, a 66% patency rate was found in both the grafts and the native vessels. The native coronary vessels were more likely to be patent when the left internal mammary artery was used as a conduit than when a saphenous vein bypass graft was used.ConclusionThe lack of a significant difference in postoperative complications in patients who underwent CABG with or without CE may indicate that CE does not expose patients to a higher risk of complications. Since most of the endarterectomized vessels were shown to be patent during the follow-up period, we propose that endarterectomy is a viable option for patients with severely diseased vessels.

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Section: Introductionmentioning

confidence: 99%

Outcome and Graft Patency in Coronary Artery Bypass Grafting with Coronary Endarterectomy

Nemati

Astaneh

Khosropanah

2015

Korean J Thorac Cardiovasc Surg

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“…Looking at our cohort of patients referred for CABG, more than 75% of patients had DM, hypertension and dyslipidemia, and even more, 10% of them had previous PCI. With more diffuse CAD, complete revascularization becomes an issue with conventional CABG, hence the need to adopt alternative surgical techniques such as coronary endareterctomy (CE) [8].…”

Section: Discussionmentioning

confidence: 99%

“…Schimitto et al, reported an early mortality rate of 5% in 104 patients, with most common vessel being endactectomized was the RCA (55%) followed by LAD (35%) [22]. However, Abid et al, demonstrated an early mortality rate of 2% (cases: RCA endarterectomy 44%, and LAD endarterectomy 42%), and there was no statistical difference in mortality when compared with CABG alone [8]. Moreover, Silberman et al, showed a mortality rate with LAD endarterectomy reaching 10%, compared with non-LAD endarterectomy (4%) and CABG alone (3%) with significant p value of 0.001 [20].…”

Section: Discussionmentioning

confidence: 99%

“…Treating complex CAD with conventional coronary artery bypass surgery (CABG) yields unsatisfactory results [7]. To achieve complete revascularization in complex CAD, adjunctive surgical techniques like coronary endarterectomy (CE) are necessary [8]. CE was first introduced in 1957 by Bailey et al, and was further corroborated by multiple reports [9].…”

Section: Introductionmentioning

confidence: 99%

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Does Coronary Endarterectomy Increase Early Mortality and Morbidity Compared with Coronary Artery Bypass Surgery Alone-Single Centre Experience

Alreshidan¹,

Albabtain²,

Obied³

et al. 2014

IJCM

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Background: With increasing incidence of coronary artery disease (CAD) in Saudi Arabia and its fatal co-morbidity, this has resulted in a more complex pool of cases referred to cardiac surgeons. In selected cases, achieving optimal revascularization of diffuse CAD necessitates adjunctive techniques such as coronary endarterectomy (CE). The aim of our study is to evaluate the early mortality and post-operative morbidity related to CE. Method: Retrospective study from Jan 2009 to Dec 2010. Inclusion of 186 patients: 38 patients had CABG with CE and 148 patients had CABG alone. Results: Pre-operative percutaneous coronary intervention (PCI) was higher in the CE with CABG group (25.8%) compared with CABG alone (8.9%) (p = 0.009). Intra-operative data showed a higher mean cardiopulmonary bypass time (CBT) of 160 minutes and a mean cross-clamp time (XCT) of 109 minutes in the CE with CABG, compared to a mean CBT of 129 minutes and a mean XCT of 87 minutes in the CABG alone group (p = 0.001). The most common vessel endarterectomized was left anterior descending artery (LAD) (47%) followed by right coronary artery (RCA) (22%). Post-operatively, the mortality amongst the CE with CABG group (7.9%) was higher than CABG only group (1.4%), however it wasn't statistically significant (p = 0.06). With regards to morbidity, hemodynamic instability requiring intra aortic balloon pump (HIR-IABP) was higher in the CE with CABG group (10.5%) compared to the CABG only group (1.4%) (p = 0.018). Conclusion: Our study showed that CE when combined with CABG wasn't associated with a higher mortality rate when compared with CABG alone.

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Adjunct coronary endarterectomy increases cerebrovascular accident after coronary artery bypass grafting: a meta-analysis of 17,600 patients

Wang

Gao

et al. 2015

International Journal of Cardiology

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Hospital Outcome of Coronary Artery Bypass Grafting and Coronary Endarterectomy

Cited by 10 publications

References 15 publications

Outcome and Graft Patency in Coronary Artery Bypass Grafting with Coronary Endarterectomy

Outcome and Graft Patency in Coronary Artery Bypass Grafting with Coronary Endarterectomy

Does Coronary Endarterectomy Increase Early Mortality and Morbidity Compared with Coronary Artery Bypass Surgery Alone-Single Centre Experience

Adjunct coronary endarterectomy increases cerebrovascular accident after coronary artery bypass grafting: a meta-analysis of 17,600 patients

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