CORONARY ENDARTERECTOMY AND PATCH ANGIOPLASTY FOR DIFFUSE CORONARY ARTERY DISEASE. A PROSPECTIVE ANALYSIS OF 22 CASES
Basrah journal of surgery
Diffuse coronary artery disease (CAD) is a surgical challenge in which conventional coronary artery bypass grafting (CABG) may not achieve adequate myocardial revascularization unless adjuvant procedures such as coronary endarterectomy and coronary patch angioplasty (CPA) are added. The aim of this prospective study is to evaluate the outcome of these procedures in our institution in view of the relevant literature. Data of all patients who underwent CPA±CABG by one surgeon in our institution
... =22) between April 2018 and April 2019 were collected. Patients underwent open coronary endarterectomy and onlay patch of left internal mammary artery (LIMA) or a venous patch under cardiopulmonary bypass (CPB). Of 167 CABG procedures, 22 were combined with CPA. There were 15 (68.2%) males. Age ranged between 43-72 years with a mean of 59. patients included 19 isolated left anterior descending arteries (LADs), two right coronary arteries and one obtuse marginal branch. The CPB time was 88-198 minutes and the aortic cross clamp time was 40-125 minutes. The patients had (including LAD) 2-4 vessel diseases. The average ICU stay was 29±14 hours and mean hospital stay was 5 days with no complications apart from atrial fibrillation (n=4, 18.2%). The follow-up period ranged from 4 to 14 months. On the 40th postoperative day, coronary CT angiography revealed patent grafts. No patient died due to CAD. In conclusion, coronary endarterectomy and angioplasty is a safe and highly rewarding procedure in potentially inoperable patients with diffuse coronary artery disease.