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Coronary Endarterectomy Improve Left Ventricle Ejection Fraction After Coronary Artery Bypass Grafting Surgery

Received: 28 March 2019     Accepted: 28 May 2019     Published: 10 June 2019
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Abstract

The diffusely diseased coronary artery is a challenge for cardiac surgeons, although coronary endarterectomy is an option for surgical reconstruction of a diffusely diseased vessel. It may assures complete revascularization of myocardium in case of diffusely diseased vessels and prevent residual ischemia but it has not been widely used. recently cardiac surgeons are performing and increasing number of coronary artery endarterectomy and it has evolved as an important adjuvant procedure in coronary artery bypass grafting surgery. we reviewed the early clinical and hemodynamic out comes with echocardiography of 22 patients undergoing coronary artery endarterectomy of left anterior descending artery (LAD) diagonal branches (D1 or D2) and right coronary artery and posterior descending artery (RCA and PDA) with patch plasty method using left internal mammary artery (LIMA) and saphenous vein graft (SVG) between January 2017 and June 2018. mean follow up of all patients were 3-6 months postoperatively, Left internal mammary artery (LIMA) anastomosed to left anterior descending artery (LAD) with endarterectomy and artery patch plasty in 12 (54, 5%) patients, saphenous vein graft (SVG) anastomosed to left anterior descending artery (LAD) with endarterectomy and vein patch plasty in 2 (9%) patients, and saphenous vein graft (SVG) to Right coronary artery (RCA) Diagonal (D1) and posterior descending artery (PDA) with endarterectomy and vein patch plasty in 9 (40.9%) patients. Postoperative mortality was 0% and echocardiographic assessment done by modified Simpson method on outpatient department (OPD) basis, 7 patients had left ventricle ejection fraction of (50-55%) preoperatively with no changes on postoperative period and 7 patients had improvement of left ventricle ejection fraction from (30-35%) preoperatively to (40-45%) in postoperative period. principle goal in coronary artery bypass grafting surgery (CABG) is to achieve complete revascularization of diseased coronary arteries, in particular the left anterior descending artery (LAD) is very important vessel because incomplete revascularization of the LAD has been proven to be a predictor of worse mortality after coronary artery bypass grafting surgery (CABG). Recent publications have revealed that coronary endarterectomy is a safe procedure and demonstrated favorable long term out comes. In our experience coronary endarterectomy has been performed with good clinical and hemodynamic out comes with echocardiography.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 5, Issue 2)
DOI 10.11648/j.ijcts.20190502.13
Page(s) 41-46
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Cardiac Surgery, Coronary Artery Bypass Grafting Surgery, Coronary Endarterectomy

References
[1] Nishigawa K, Fukui T, Takanashi S. Coronary endarterectomy for the diffusely diseased coronary artery. Gen Thorac. Cardiovasc Surg 2014; 62: 461-7.
[2] Wang J, Gu C, Yu W, Gao M, Yu U. Short- and long-term patient outcomes from combined coronary endarterectomy and coronary artery bypass grafting: a meta-analysis of 63, 730 patients (PRISMA). Medicine (Baltimore) 2015; 94: e1781.
[3] Akgun S, Isbir CS, Yildirim T, Civelek A, Arsan S. Results of adjunctive coronary endarterectomy in 548 patients. Heart Surg Forum 2008; 11: E66-70.
[4] Marinelli G, Chiappini B, Di Eusanio M, Di BartolomeoR, Caldarera I, Marrozzini C, MarzocchiA, Pierangeli A. Bypass grafting with coronary endarterectomy: immediate and long-term results. J Thorac Cardiovasc Surg 2002; 124: 553-60.
[5] Byrne JG, Karavas AN, Gudbjartson T, Leacche M, Rawn JD, Couper GS, Rizzo RJ, Cohn LH, Aranki SF. Left anterior descending coronary endarterectomy: early and late results in 196 consecutive patients. Ann Thorac Surg 2004; 78: 867-73.
[6] Fukui T, Takanashi S, Hosoda Y. Long segmental reconstruction of diffusely diseased left anterior descending coronary artery with left internal thoracic artery with or without endarterectomy. Ann Thorac Surg 2005; 80: 2098-105.
[7] Myers PO, Tabata M, Shekar PS, Couper GS, Khalpey ZI, Aranki SF. Extensive endarterectomy and reconstruction of the left anterior descending artery: early and late outcomes. J Thorac Cardiovasc Surg 2012; 143: 1336-40.
[8] Sirivella S, Gielchinsky I, Parsonnet V. Results of coronary artery endarterectomy and coronary artery bypass grafting for diffuse coronary artery disease. Ann Thorac Surg 2005; 80: 1738-44.
[9] Schwann TA, Zacharias A, Riordan CJ, Durham SJ, Shah AS, Habib RH. Survival and graft patency after coronary artery bypass grafting with coronary endarterectomy: role of arterial versus vein conduits. Ann Thorac Surg 2007; 84: 25-31.
[10] Tiruvoipati R, Loubani M, Peek G. Coronary endarterectomy in the current era. Curr Opin Cardiol 2005; 20: 517-20.
[11] Shapira OM, Akopian G, Hussain A, Adelstein M, Lazar HL, Aldea GS, Shemin RJ. Improved clinical outcomes in patients undergoing coronary artery bypass grafting with coronary endarterectomy. Ann Thorac Surg 1999; 68: 2273-8.
[12] Eryilmaz S, Inan MB, Eren NT, Yazicioglu L, Corapcioglu T, Akalin H. Coronary endarterectomy with off-pump coronary artery bypass surgery. Ann Thorac Surg. 2003; 75: 865-9.
[13] Vohra HA, Kanwar R, Khan T, Dimitri WR. Early and late outcome after off-pump coronary artery bypass graft surgery with coronary endarterectomy: a single-center 10-year experience. Ann Thorac Surg 2006; 81: 1691-6.
[14] Fukui T, Takanashi S, Hosoda Y, Suehiro S. Early and midterm results of off-pump coronary artery bypass grafting. Ann Thorac Surg 2007; 83: 115-9.
[15] Kleisli T, Cheng W, Jacobs MJ, Mirocha J, Derobertis MA, Kass RM, Blanche C, Fontana GP, Raissi SS, Magliato KE, Trento A. In the current era, complete revascularization improves survival after coronary artery bypass surgery. J Thorac Cardiovasc Surg 2005; 129: 1283-91.
[16] Nathoe HM, Buskens E, Jansen EW, Suyker WJ, Stella PR, Lahpor JR, van Boven WJ, van Dijk D, Diephuis JC, Borst C, Moons KG, Grobbee DE, de Jaegere PP. Role of coronary collaterals in off-pump and on-pump coronary bypass surgery. Circulation 2004; 110: 1738-42.
[17] Shapira OM, Akopian G, Hussain A, et al. Improved clinical outcomes in patients undergoing coronary artery bypass grafting with coronary endarterectomy. Ann Thorac Surg 1999; 68: 2273-8.
Cite This Article
  • APA Style

    Manochihr Timorian, Mirwais Amiri, Abdullah Alimi. (2019). Coronary Endarterectomy Improve Left Ventricle Ejection Fraction After Coronary Artery Bypass Grafting Surgery. International Journal of Cardiovascular and Thoracic Surgery, 5(2), 41-46. https://doi.org/10.11648/j.ijcts.20190502.13

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    ACS Style

    Manochihr Timorian; Mirwais Amiri; Abdullah Alimi. Coronary Endarterectomy Improve Left Ventricle Ejection Fraction After Coronary Artery Bypass Grafting Surgery. Int. J. Cardiovasc. Thorac. Surg. 2019, 5(2), 41-46. doi: 10.11648/j.ijcts.20190502.13

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    AMA Style

    Manochihr Timorian, Mirwais Amiri, Abdullah Alimi. Coronary Endarterectomy Improve Left Ventricle Ejection Fraction After Coronary Artery Bypass Grafting Surgery. Int J Cardiovasc Thorac Surg. 2019;5(2):41-46. doi: 10.11648/j.ijcts.20190502.13

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  • @article{10.11648/j.ijcts.20190502.13,
      author = {Manochihr Timorian and Mirwais Amiri and Abdullah Alimi},
      title = {Coronary Endarterectomy Improve Left Ventricle Ejection Fraction After Coronary Artery Bypass Grafting Surgery},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {5},
      number = {2},
      pages = {41-46},
      doi = {10.11648/j.ijcts.20190502.13},
      url = {https://doi.org/10.11648/j.ijcts.20190502.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20190502.13},
      abstract = {The diffusely diseased coronary artery is a challenge for cardiac surgeons, although coronary endarterectomy is an option for surgical reconstruction of a diffusely diseased vessel. It may assures complete revascularization of myocardium in case of diffusely diseased vessels and prevent residual ischemia but it has not been widely used. recently cardiac surgeons are performing and increasing number of coronary artery endarterectomy and it has evolved as an important adjuvant procedure in coronary artery bypass grafting surgery. we reviewed the early clinical and hemodynamic out comes with echocardiography of 22 patients undergoing coronary artery endarterectomy of left anterior descending artery (LAD) diagonal branches (D1 or D2) and right coronary artery and posterior descending artery (RCA and PDA) with patch plasty method using left internal mammary artery (LIMA) and saphenous vein graft (SVG) between January 2017 and June 2018. mean follow up of all patients were 3-6 months postoperatively, Left internal mammary artery (LIMA) anastomosed to left anterior descending artery (LAD) with endarterectomy and artery patch plasty in 12 (54, 5%) patients, saphenous vein graft (SVG) anastomosed to left anterior descending artery (LAD) with endarterectomy and vein patch plasty in 2 (9%) patients, and saphenous vein graft (SVG) to Right coronary artery (RCA) Diagonal (D1) and posterior descending artery (PDA) with endarterectomy and vein patch plasty in 9 (40.9%) patients. Postoperative mortality was 0% and echocardiographic assessment done by modified Simpson method on outpatient department (OPD) basis, 7 patients had left ventricle ejection fraction of (50-55%) preoperatively with no changes on postoperative period and 7 patients had improvement of left ventricle ejection fraction from (30-35%) preoperatively to (40-45%) in postoperative period. principle goal in coronary artery bypass grafting surgery (CABG) is to achieve complete revascularization of diseased coronary arteries, in particular the left anterior descending artery (LAD) is very important vessel because incomplete revascularization of the LAD has been proven to be a predictor of worse mortality after coronary artery bypass grafting surgery (CABG). Recent publications have revealed that coronary endarterectomy is a safe procedure and demonstrated favorable long term out comes. In our experience coronary endarterectomy has been performed with good clinical and hemodynamic out comes with echocardiography.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Coronary Endarterectomy Improve Left Ventricle Ejection Fraction After Coronary Artery Bypass Grafting Surgery
    AU  - Manochihr Timorian
    AU  - Mirwais Amiri
    AU  - Abdullah Alimi
    Y1  - 2019/06/10
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijcts.20190502.13
    DO  - 10.11648/j.ijcts.20190502.13
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 41
    EP  - 46
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20190502.13
    AB  - The diffusely diseased coronary artery is a challenge for cardiac surgeons, although coronary endarterectomy is an option for surgical reconstruction of a diffusely diseased vessel. It may assures complete revascularization of myocardium in case of diffusely diseased vessels and prevent residual ischemia but it has not been widely used. recently cardiac surgeons are performing and increasing number of coronary artery endarterectomy and it has evolved as an important adjuvant procedure in coronary artery bypass grafting surgery. we reviewed the early clinical and hemodynamic out comes with echocardiography of 22 patients undergoing coronary artery endarterectomy of left anterior descending artery (LAD) diagonal branches (D1 or D2) and right coronary artery and posterior descending artery (RCA and PDA) with patch plasty method using left internal mammary artery (LIMA) and saphenous vein graft (SVG) between January 2017 and June 2018. mean follow up of all patients were 3-6 months postoperatively, Left internal mammary artery (LIMA) anastomosed to left anterior descending artery (LAD) with endarterectomy and artery patch plasty in 12 (54, 5%) patients, saphenous vein graft (SVG) anastomosed to left anterior descending artery (LAD) with endarterectomy and vein patch plasty in 2 (9%) patients, and saphenous vein graft (SVG) to Right coronary artery (RCA) Diagonal (D1) and posterior descending artery (PDA) with endarterectomy and vein patch plasty in 9 (40.9%) patients. Postoperative mortality was 0% and echocardiographic assessment done by modified Simpson method on outpatient department (OPD) basis, 7 patients had left ventricle ejection fraction of (50-55%) preoperatively with no changes on postoperative period and 7 patients had improvement of left ventricle ejection fraction from (30-35%) preoperatively to (40-45%) in postoperative period. principle goal in coronary artery bypass grafting surgery (CABG) is to achieve complete revascularization of diseased coronary arteries, in particular the left anterior descending artery (LAD) is very important vessel because incomplete revascularization of the LAD has been proven to be a predictor of worse mortality after coronary artery bypass grafting surgery (CABG). Recent publications have revealed that coronary endarterectomy is a safe procedure and demonstrated favorable long term out comes. In our experience coronary endarterectomy has been performed with good clinical and hemodynamic out comes with echocardiography.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • Department of Cardiothoracic and Vascular Surgery and Adult Cardiology Amiri Medical Complex, Kabul, Afghanistan

  • Department of Cardiothoracic and Vascular Surgery and Adult Cardiology Amiri Medical Complex, Kabul, Afghanistan

  • Department of Cardiothoracic and Vascular Surgery and Adult Cardiology Amiri Medical Complex, Kabul, Afghanistan

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