Results of coronary artery bypass grafting with coronary endarterectomy

Background: In this study, we evaluated the outcomes of the patients who underwent coronary endarterectomy. Methods: Between January 2007 and January 2010, 3500 consecutive patients who underwent coronary artery bypass graft (CABG) surgery with coronary endarterectomy in Cardiovascular Surgery Clinic at Sifa University Hospital, Izmir were analyzed retrospectively. The patients were divided into two subgroups, including those undergoing only CABG surgery (group 1; n=2688; 1505 males, 1183 females; mean age 61.0 +/- 6.3 years; range 42 to 73 years) and those undergoing CABG surgery with coronary endarterectomy (group 2; n=812; 544 males, 268 females; mean age 64.2 +/- 8.4 years; range 48 to 75 years). At six months and three years, repeated coronary angiography (CAG) was performed on 5% of the patients in both groups. Both groups were compared in respect of operative results and postoperative complications, existing risk factors and graft patency rate, and baseline demographic characteristics of the patients. Results: No statistically significant difference was found between the groups in terms of the postoperative complication rates (p>0.05). The patency rates of the grafts as assessed by repeated CAG at six months were 91.9% and 92.3% in the group 1 and 2, respectively (p>0.05). At three years, CAG showed a patency rate of 82% for group 1 and 82.6% for group 2 (p>0.05). At the end of six months, the patency rate of internal thoracic arterial graft was 100% and 97.6%, while it was 93.3% and 89.4% at the end of three years in group 1 and 2, respectively. Conclusion: Endarterectomy is safe when combined with CABG surgery, resulting in no adverse effect on graft patency rate in the long-term, particularly in the patients with diffuse coronary atherosclerosis.