Key result
Coronary endarterectomy during CABG was associated with an early postoperative mortality rate of 10.2%, with significantly higher mortality observed in females, patients with low ejection fraction, and those undergoing left anterior descending artery endarterectomy.
Why the study?
Complete revascularization is the main goal of coronary bypass surgery, and this study aimed to identify factors affecting early mortality and morbidity in patients undergoing coronary endarterectomy.
What are the factors affecting early mortality and morbidity in patients undergoing coronary endarterectomy during CABG?
Cohort (n=98)
No
What are the factors affecting early mortality and morbidity in patients undergoing coronary endarterectomy during CABG?
Coronary endarterectomy during CABG carries a high early mortality and morbidity risk, particularly in women, patients with low ejection fraction, and those undergoing LAD endarterectomy.
Supports caution with coronary endarterectomy in CABG for high-risk patients; leaves open need for randomized data on selection.
Objectives: Main goal of coronary bypass surgery is complete revascularization. In some coronary endarterectomy applied patient groups, complete revascularization is inevitable. In this study, it was aimed to reveal factors affecting early mortality and morbidity in patients undergoing coronary endarterectomy.Methods: Retrospective records of preoperative, operative, and postoperative data of 98 patients undergoing coronary artery bypass grafting (CABG) with coronary endarterectomy between January 1, 2012, and October 30, 2016, were reviewed.Results: A total of 113 endarterectomies were performed in different coronary arteries. Of the patients, 22 (22.4%) were female and 76 (77.6%) were male. The mean of ages was 60.4 ± 9.9 (range; 36-81 years). A positive inotropic requirement was required in 68 (69.1%) patients and intra-aortic balloon pump was required for 23 (23.4%) patients. Mortality was observed in 10 patients (10.2%). Peroperative myocardial infarction was observed in 17 (17.3%) patients. Mortality rate was significantly higher in patients whose left ventricular ejection fraction was 30 or less and who had a higher risk in EuroSCORE (p < 0.001). When compared with the other vessels, mortality ratewas found to be higher for left anterior descending coronary artery endarterectomy (p = 0.038). Mortality in female patients undergoing endarterectomy was higher than male patients (p = 0.023). Conclusions: Mortality and morbidity are higher in patients undergoing coronary endarterectomy when compared to conventional CABG operations. However, it is a method that can be applied by considering certain risk factors.
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Güvenç et al. (2019) conducted a cohort in Long segment coronary artery disease (n=98). Coronary endarterectomy during CABG was evaluated on Early postoperative mortality. Coronary endarterectomy during CABG was associated with an early postoperative mortality rate of 10.2%, with significantly higher mortality observed in females, patients with low ejection fraction, and those undergoing left anterior descending artery endarterectomy.
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