Journal of Cardio-Thoracic Medicine

Journal of Cardio-Thoracic Medicine

Early Clinical Outcomes and Mortality of Coronary Endarterectomy in the Left Anterior Descending Artery: A Single-Center Experience

Document Type : Original Article

Authors
Hamid Hoseinikhah 1
Mohammad Abbassi Teshnisi 2
Ahmadreza Zarifian 3
Yasamin Moeinipour 4
Aliasghar Moeinipour 5
1 Cardiac Surgeon, Faculty of Medicine, Mashhad University of Medical Sciences, Atherosclerosis Prevention Research Center, Imam Reza Hospital. Iran
2 Cardiac Surgeon, Department of cardiac surgery, Cardio-Thoracic Surgery & Transplant Research Center, Emam Reza hospital, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran. .
3 Medical Student, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Medical Student, Faculty of Medicine, Mashhad University of Medical Sciences, Iran
5 Cardiac Surgeon, Atherosclerosis Prevention Research Center, cardiac surgery Imam Reza Hospital, Mashhad University of Medical Sciences,
10.22038/jctm.2016.7418
Abstract
Introduction: Although coronary endarterectomy is not an ideal procedure, it is the only available option for cardiac surgeons in some patients with diffuse coronary artery disease. Based on the majority of conducted studies, the results of coronary endarterectomy (including survival, graft patency, and recurrence of the symptoms of myocardial ischemia) are less prevalent than standard coronary artery bypass grafting. Generally, the left anterior descending artery (LAD) is the most commonly involved artery in coronary endarterectomy. The aim of this study was evaluate clinical and early results of  Endarterectomy of LAD artery.
Materials & Methods:  In total, 30 cases of coronary endarterectomy of the LAD were studied from January 2015 until January 2016.this is a retrospective study that  Endarterectomy procedure was performed in Imamreza hospital of Mashhad university of medical sciences.
Results: The mean age of the subjects was 63±4.5 years (range: 45-78 years). As the findings revealed, eighteen patients were male (60%), and the mean ejection fraction index was 43±5.1 (range: 15-60). Also, prior history of myocardial infarction was documented in 8 (26%) patients. The mortality rate among patients was estimated at 6.6% (n=2). In total, 12 (40%) and 7 (23%) patients required high-dose inotropic support and intra-aortic balloon pump, respectively. Risk of preoperative myocardial infarction was observed in 5 (16.5%) cases, and 3 (10%) patients required re-exploration due to significant hemorrhage.
Conclusion: If coronary endarterectomy of the LAD is performed by experienced cardiac surgeons, favorable outcomes can be obtained.
Keywords
CABG
Coronary Endarterectomy
Left Anterior Descending Artery
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Journal of Cardio-Thoracic Medicine
Volume 4, Issue 3
Summer 2016
Pages 480-483