Coronary Artery Endarterectomy during Coronary Artery Bypass Grafting: A Solution for Complete Revascularization
- #AC/COR 02-O-5
- Adult Cardiac Surgery/Coronary. SESSION-2
- Oral
Coronary Artery Endarterectomy during Coronary Artery Bypass Grafting: A Solution for Complete Revascularization
Lalitaditya Malik
Kota Heart Institute, Kota Rajasthan, India, Kota, India
Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–A
Abstract
BACKGROUND
Coronary Artery Bypass Grafting (CABG) is one of the most
frequently done cardiac surgical procedures. However, with the advancements in
catheter-based interventional procedures, the category of patients taken up for
CABG is gradually being restricted to more high-risk group. Performance of Off pump
coronary artery bypass grafting (OPCAB) with concomitant coronary artery
endarterectomy(CE) in patients with severe coronary disease provides more
complete revascularization.We examined the technique and early outcomes of
OPCAB with endarterectomy (CE).
MATERIALS AND METHODS
This is a single institutional retrospective study with 32 patients(26 males, 6 females) underwent concomitant off-pump CE and CABG from 1 october 2016 through 31 october 2017. Average number of coronary bypass grafts were 2.4±0.8.10 CE procedures were performed with saphenous vein patch. 7 involved left anterior descending artery (LAD) CE with left internal mammary artery (LIMA) conduits. The remaining 3 were diagonal branch artery (D1) CE with saphenous vein bypass conduits.
RESULTS
The incidence of postoperative MI was 9%. The 30-day
mortality was 3.12% from complications of bowel ischaemia and three patients
with septicaemia associated with prolonged intubation. The mean operating time
was 138±22 minutes.
CONCLUSION
We have shown that the effect of OPCABG with CE appears to be safe and early outcomes are encouraging. Hence, diffuse disease requiring endarterectomy should not be considered a contraindication to OPCABG. Surgical skills and the suitability criteria of the patients are very important in this regard.