Coronary endarterectomy—angiographic and clinical results
Autor: | Christian Landou, Gunilla Forssell, Roberto Welti, Torbjörn Ivert |
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Rok vydání: | 1989 |
Předmět: |
Male
Reoperation medicine.medical_specialty medicine.medical_treatment Coronary Disease Endarterectomy Anastomosis Angina Pectoris Internal medicine Humans Medicine Myocardial infarction Derivation Circumflex Vascular Patency medicine.diagnostic_test business.industry Middle Aged Prognosis medicine.disease Surgery Radiography Stenosis medicine.anatomical_structure Angiography cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Artery |
Zdroj: | Scandinavian Journal of Thoracic and Cardiovascular Surgery. 23:95-102 |
ISSN: | 0036-5580 |
Popis: | Of 75 patients who underwent coronary endarterectomy, 16% had left main stem stenosis, 4% one-vessel, 27% two-vessel and 53% three-vessel disease. On average 2.9 grafts per patient were inserted, in conjunction with 82 manual endarterectomies (38 right coronary, 35 left anterior descending, 9 circumflex branches). In 68/75 cases (91%) the endarterectomy was not preplanned and in 39 cases (52%) greater than or equal to 3 cm of the atherosclerotic core was removed. All four early deaths (5%) followed endarterectomy of LAD. Acute perioperative myocardial infarction was confirmed in 19% and probable in further 8%. At angiography 1-139 (median 25) months postoperatively, all three internal mammary artery grafts and 19/34 saphenous vein grafts (56%) to endarterectomized vessels were patent, though in 4 of the 19, the coronary artery was occluded distal to the anastomosis. In addition 17/18 conventional internal mammary artery (94%) and 48/59 conventional saphenous vein grafts (81%) were patent. The vein graft patency rate was not significantly influenced by postoperative anticoagulant therapy, but was significantly increased among patients with relief of angina: 44% reported freedom from angina and 92% at least some relief after a median of 3 years. The 5-year and 10-year survival rates were 85% and 68%. Despite the increased risk, endarterectomy can be recommended for severely diseased major coronary arteries. |
Databáze: | OpenAIRE |
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