Coronary endarterectomy with off-pump coronary artery bypass surgery.
BACKGROUND
The aim of this study is to review our experience in coronary artery endarterectomy performed without cardiopulmonary bypass.


METHODS
Between May 1998 and June 2000 off-pump coronary endarterectomy was performed on 11 patients who had unstable angina pectoris. The mean ejection fraction (EF) was 26.3 +/- 4.4, and all of the patients were New York Heart Association (NYHA) III or IV. Off-pump open left anterior descending (LAD) endarterectomy was performed on 7 patients, and closed endarterectomy of the right coronary artery (RCA) was done on the remaining 4.


RESULTS
There were no deaths. None of the procedures was converted to on-pump operation; all the endarterectomies and bypasses were performed on the beating heart. All patients were completely revascularized, the left internal mammary artery was bypassed to the LAD in all operations, and all other grafts were of saphenous vein. At the end of the first year all bypasses to the endarterectomized arteries were patent. The overall patency rate was 95.6%. The mean postoperative EF was 34.7 +/- 9.1, which was significantly higher than the preoperative one (p < 0.05). At the end of the first year 9 patients were NYHA I or II and all were angina free in Canadian Cardiovascular Society class 0 or I.


CONCLUSIONS
Endarterectomy without cardiopulmonary bypass can be performed in patients with severe left ventricular dysfunction who are expected to benefit from the complete revascularization.
Eryilmaz
Sadik
S
Department of Cardiovascular Surgery, Ankara University School of Medicine, Ankara, Turkey. sadikeryilmaz@hotmail.com
Inan
Mustafa Bahadir
MB
Eren
Neyyir Tuncay
NT
Yazicioglu
Levent
L
Corapcioğlu
Tumer
T
Akalin
Hakki
H
D000368:Aged; D000789:Angina, Unstable / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011183:Postoperative Complications / Q000209:etiology; D014680:Veins / Q000637:transplantation; D018487:Ventricular Dysfunction, Left / Q000601:surgery