| Background: Diffuse coronary artery disease is a challenge for both percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG).Coronary artery endarterectomy(CE)coupled with CABG is an alternative method to achieve complete revascularization.The mid-and long-term results of CE are largely questionable.The aim is to evaluate the early and mid-term graft patency of concomitant coronary artery endarterectomy and CABG.Method: All the patients who had undergone concomitant Coronary endarterectomy(CE)and CABG(Coronary Artery bypass graft)for diffuse and calcified coronary artery disease were identified from our database.The patients(1)with complete operative records,(2)with good graft flow during surgery,(3)who were discharged,(4)with a one-month/ one-year follow-up were included in our study.The follow-up information was obtained directly from our out-patient department and by telephone contact.Result: CE was performed on all 20 cases that were included in the study.Male to female patients ratio was 18:2.The mean age of the patients was 61.60 ± 6.7 years.More than 95% of the patients had LIMA-LAD anastomosis while 5% of the patients had RIMA-LAD.SVG-DIA and SVG-OM were 40%.More than 90% had SVG-RCA and 30% had SVG-PDA respectively.About 75.4% of the patients had history of smoking,57.9% had diabetes and 75% had hypertension.Transit Time Flow Measurements were;(mean graft flow for LIMA-LAD was 19.8±9.65,SVG-DIA 39.4±16.22,SVG-OM 23.6±10.39,SVG-RCA 24.5±14.8.The PI was measured as;LIMA-LAD 3.04±1.25,SVG-DIA 2.2±0.53,SVG-OM 3.72±1.40,SVG-RCA 3.05±2.0.Conclusion: In patients with diffuse and severely calcified coronary artery disease,CE(Coronary endarterectomy)is a safe and feasible technique for a selected group of patients with excellent short-term survival rates and graft patency rates.CE produces better overall results when performed on the LAD,and grafted over with the LIMA.Similar outcomes are obtained with both on-pump and off-pump surgery. |
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