title: [Coronary endarterectomy: state of the art].
abstract: Coronary endarterectomy (EA) allows to recanalize and bypass what appear to be an otherwise inoperable vessel. Although the application of this procedure is still controversial, there is now an increasing tendency to use the EA more frequently and recent studies confirm this trend. A variety of individualized techniques of performing coronary EA (local EA, conventional "blind" EA, open EA with coronary reconstruction, laser EA) are analyzed. Technical aspects, indications and results (operative risk, symptomatic improvement, grafts patency) of each procedure are evaluated on the basis of the current experiences. Although hospital mortality and perioperative infarction rates are moderately higher than in routine grafting, it is stressed that EA is a valuable supplement to coronary artery bypass grafting extending the indications of myocardial revascularization: a) larger number of conventionally inoperable patients can benefit from the surgical treatment; b) more complete revascularizations are possible in patients with diffuse coronary disease.
mesh_terms: D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery*; D004691:Endarterectomy / Q000379:methods; D006801:Humans; D053685:Laser Therapy; D012306:Risk
vernacular_title: Endoarteriectomia coronarica: stato dell'arte.