title: Coronary endarterectomy for the diffusely diseased coronary artery.
abstract: The diffusely diseased coronary artery is challenging for cardiac surgeons because diffuse atheromatous lesions frequently render it unsuitable for conventional distal grafting. Coronary endarterectomy was introduced in the 1950s as a treatment option for diffusely diseased coronary arteries. However, initial studies demonstrated high operative mortality and morbidity associated with coronary endarterectomy; therefore, many cardiac surgeons have been reluctant to perform this procedure. With percutaneous coronary interventions increasingly being applied to coronary artery disease, the incidence of complex and diffuse coronary artery disease in patients referred for coronary artery bypass surgery has been increasing, and recent advances in the surgical technique and perioperative management have improved the surgical outcomes of coronary endarterectomy. In this review article, we sought to discuss coronary endarterectomy for the diffusely diseased coronary artery.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo, 183-0003, Japan, nippie550102@yahoo.co.jp.
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nishigawa
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukui
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
mesh_terms: D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000601:surgery*; D003327:Coronary Disease / Q000601:surgery; D003331:Coronary Vessels / Q000601:surgery*; D004691:Endarterectomy / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome