Ahmet Fatih Özyazıcıoğlu, Mehmet Tuğrul Göncü, Mesut Engin, Orhan Güvenç, Mustafa Çağdaş Çayır

Effects of coronary endarterectomy on postoperative early results in long segment coronary artery disease

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 undergoingcoronary artery bypass grafting (CABG) with coronary endarterectomy between January 1, 2012, and October30, 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). Apositive inotropic requirement was required in 68 (69.1%) patients and intra-aortic balloon pump was requiredfor 23 (23.4%) patients. Mortality was observed in 10 patients (10.2%). Peroperative myocardial infarctionwas observed in 17 (17.3%) patients. Mortality rate was significantly higher in patients whose left ventricularejection fraction was 30 or less and who had a higher risk in EuroSCORE (p < 0.001). When compared withthe 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 certainrisk factors.

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