[Coronary revascularization by long endarterectomy and reconstruction].
Endarterectomy and reconstruction of the coronary arteries is a technique for patients with diffuse coronary disease and in whom coronary bypass grafting is contraindicated. In a serie of 418 patients undergoing coronary bypass between May 1988 and April 1990, 55 had endarterectomy and reconstruction of a coronary artery. The mean age was 62.2 years (44-80 years). Twenty-five patients had class III (NYHA) angina and 30 had class IV angina. On the coronary angiogram, 10 patients had double-vessel disease and 45 had triple vessel disease. Endarterectomy and reconstruction were performed on one coronary artery in 53 patients and on two coronary arteries in 2 patients. At mean of 2.6 grafts per patient were performed. Four patients died during the perioperative period. Ten had a perioperative myocardial infarction. No other complications were noted. No residual postoperative angina was present. Five patients had a follow-up angiogram during the first postoperative month. All grafts were patent and correctly revascularised the endarterectomised artery and branches. These satisfactory preliminary results suggest that endarterectomy and reconstruction of the coronary arteries is a reliable and reproducible technique for coronary grafting. It is indicated in patients with diffuse atheromatous coronary disease who were previously not considered for surgery.
Chaptal
P A
PA
Service de Chirurgie Thoracique et Cardiovasculaire, CHU, Hôpital Saint-Eloi, Montpellier.
Séguin
J R
JR
Frapier
J M
JM
Malak
M
M
Grolleau
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D004691:Endarterectomy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care
Revascularisation coronaire par endartériectomie longue et reconstruction.