Early and late outcomes of multiple coronary endarterectomy.
OBJECTIVE
Coronary endarterectomy has been shown to be an effective adjunctive technique of revascularization for diffuse coronary artery disease. However, outcomes of multiple coronary endarterectomy (MCE) have not been well investigated. We sought to examine early and late results of this technique.


METHODS
Between January 1992 and June 2006, 58 consecutive patients underwent coronary endarterectomy in more than one coronary artery territories, representing 6.5% of total coronary endarterectomy during the same period. Early and late outcomes were retrospectively analyzed.


RESULTS
The mean age was 64 years. Forty-one patients (70.7%) had coronary endarterectomy in the left anterior descending artery and right coronary artery territories; five (8.6%) in the left anterior descending artery and circumflex artery territories; eight (13.8%) in the circumflex artery and right coronary artery territories; and four (6.9%) in the left anterior descending artery, circumflex artery, and right coronary artery territories. Operative mortality was 12.1% (7/58). The incidence of perioperative myocardial infarction was 25.9% (15/58). The median length of hospital stay was seven days. Actuarial five- and 10-year survivals were 64% and 36%, respectively.


CONCLUSIONS
MCE may be a reasonable option for revascularization of multiple diffuse coronary artery disease. However, early and late outcomes are relatively poor and the indication should be carefully considered.
Tabata
Minoru
M
Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Shekar
Prem S
PS
Couper
Gregory S
GS
Aranki
Sary F
SF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D004691:Endarterectomy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome