Coronary endarterectomy: new flavors from old recipes

J Cardiol. 2014 Jun;63(6):397-401. doi: 10.1016/j.jjcc.2014.02.005. Epub 2014 Mar 24.

Abstract

Coronary endarterectomy is an old surgical procedure against coronary artery disease first described by Baily et al. in 1957. Despite its first adverse results, several current publications have shown that coronary endarterectomy with on-pump or off-pump coronary artery bypass grafting can be safely performed with acceptable mortality, morbidity, and angiographic patency rates. Coronary endarterectomy can assure complete revascularization supplying the myocardium with satisfactory blood flow in cases of a diffusely diseased left anterior descending artery or diffuse calcification, thus preventing residual ischemia. Hence, it is important to evaluate current results, rethink this old recipe, and redefine its indications.

Keywords: Complete revascularization; Coronary endarterectomy; Diffuse coronary artery disease; Diffuse coronary calcification; Residual ischemia.

Publication types

  • Review

MeSH terms

  • Anticoagulants / administration & dosage
  • Coronary Artery Bypass / methods
  • Coronary Artery Bypass, Off-Pump
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / surgery*
  • Coronary Vessels / physiopathology
  • Coronary Vessels / surgery*
  • Endarterectomy / methods*
  • Heparin / administration & dosage
  • Humans
  • Postoperative Care
  • Safety
  • Vascular Patency
  • Warfarin / administration & dosage

Substances

  • Anticoagulants
  • Warfarin
  • Heparin