Early postoperative results of on-pump coronary endarterectomy: is it still a controversy?

Authors : Cüneyt ERİŞ, Umut Serhat SANRI, Mesut ENGİN, Senol YAVUZ

Pages : 248-255

Doi:10.18621/eurj.904571

View : 21 | Download : 9

Publication Date : 2021-05-04

Article Type : Research Paper

Abstract :Objectives: The coronary endarterectomy combined with coronary artery bypass grafting insert ignore into journalissuearticles values(CABG); is an useful but still controversial surgical technique in diffuse coronary artery disease. The aim of this study was to analyze the operative and early postoperative outcomes of the patients who underwent CABG with and without coronary endarterectomy. Methods: This retrospective study included a total of 312 consequtive patients undergoing on-pump CABG from December 2018 to December 2020 in the Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital. Patients were divided into 2 groups as those who underwent coronary endarterectomy combined with on-pump CABG insert ignore into journalissuearticles values(Group 1, n = 48); and those who underwent isolated on-pump CABG insert ignore into journalissuearticles values(Group 2, n = 264);. Peroperative variables were obtained from our hospital`s computerized database and retrospectively analyzed. Results: Previous percutaneus coronary intervention rate and the number of patients with diabetes mellitus was significantly higher in the endarterectomy group. The demographics and characteristics of the patients were similar between the two groups. The median number of distal anastomoses was 4 insert ignore into journalissuearticles values(2-5); in Group 1 and 2 insert ignore into journalissuearticles values(1-5); in Group 2. Median cross-clamp duration and perfusion times in Group 1 were longer than Group 2 insert ignore into journalissuearticles values(82 min vs. 63 min; p < 0.001 and 120 min vs. 95 min; p = 0.003, respectively);. A total of 54 coronary endarterectomy practices were performed on 48 patients, and the LAD artery insert ignore into journalissuearticles values(73%); was the most endarterectomized vessel. In Group 1, postoperative 24 hours high-sensitive troponin I levels were significantly higher than in Group 2 insert ignore into journalissuearticles values( p < 0.001);. There was no significant difference between the groups in terms of operative mortality, low cardiac output rates and perioperative myocardial infarction rates. Postoperative atrial fibrillation was significantly higher in Group 1 insert ignore into journalissuearticles values( p = 0.023);. Conclusions: Although coronary endarterectomy is a complex procedure, in patients with diffuse coronary artery disease, it is an essential and sometimes mandotary method in order to achieve complete revacularization and can be performed safely with acceptable operative and early postoperative outcomes.
Keywords : Diffuse coronary artery disease, Complete myocardial revascularization, Coronary endarterectomy, postoperative period