title: Mid-term outcome and angiographic follow-up of endarterectomy of the left anterior descending artery in patients undergoing coronary artery bypass surgery.
abstract: OBJECTIVE
  With the advancement of percutaneous coronary interventions (PCIs), more patients with diffuse coronary artery disease are referred for coronary artery bypass graft (CABG) surgery. The use of coronary endarterectomy may be useful in such cases. We reviewed our experience with left anterior descending artery endarterectomy as an adjunct to conventional CABG.
  
  
  METHODS
  Between June 2005 and 2011, 58 consecutive patients underwent left anterior descending artery endarterectomy as an adjunct to CABG. These were matched to 58 cases based on age, gender, and Parsonnet score. All data were collected prospectively in a departmental database. Postoperative complications and in-hospital mortality were analyzed. Survival curves were produced.
  
  
  RESULTS
  There was one death in the endarterectomy group (1.7%) from liver failure. There was no significant difference in postoperative complications (especially perioperative myocardial infarction) between the two groups with similar hospital mortality. Computed tomography (CT) angiography was performed in 24 patients with endarterectomy (41%), which showed 100% patency of the left internal mammary artery graft to the left anterior descending artery. Survival and freedom from intervention at a mean follow-up of 4.2 years were similar.
  
  
  CONCLUSIONS
  In patients with diffuse disease, the use of endarterectomy is a safe technique with no increase in short-term morbidity or mortality. Mid-term results are similar to nonendarterectomized patients. This technique is useful in patients with diffuse coronary artery disease.
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Royal Victoria Hospital, Montreal, Quebec, Canada.
authors.forename: Ziyad M
authors.initials: ZM
authors.lastname: Binsalamah
authors.forename: Nael
authors.initials: N
authors.lastname: Al-Sarraf
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Chaturvedi
authors.forename: Ahsan
authors.initials: A
authors.lastname: Alam
authors.forename: Lukman
authors.initials: L
authors.lastname: Thalib
authors.forename: Genevieve
authors.initials: G
authors.lastname: Belley
authors.forename: Dominique
authors.initials: D
authors.lastname: Shum-Tim
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D004691:Endarterectomy / Q000379:methods / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome