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.