title: Early results of coronary endarterectomy combined with coronary artery bypass grafting in patients with diffused coronary artery disease.
abstract: BACKGROUND
  It is still a challenge for the cardiac surgeons to achieve adequate revascularization for diffused coronary artery disease (CAD). Coronary endarterectomy (CE) offers an alternative choice of coronary artery reconstruction and revascularization. In this study, short-term result of CE combined with coronary artery bypass graft (CABG) was discussed in the treatment for the diffused CAD.
  
  
  METHODS
  From January 2012 to April 2014, 221 cases of CABG were performed by the same surgeon in our unit. Among these cases, 38 cases of CE + CABG were performed, which was about 17.2% (38/221) of the cohort. All these patients were divided into two groups: CE + CABG group (Group A) and CABG alone group (Group B). All clinical data were compared between the two groups, and postoperative complications and in-hospital mortality were analyzed. The categorical and continuous variables were analyzed by Chi-square test and Student's t-test respectively.
  
  
  RESULTS
  Diabetes mellitus, hypertension, hyperlipidemia, and peripheral vascular disease were more common in group A. In this cohort, a total of 50 vessels were endarterectomized. Among them, CE was performed on left anterior descending artery in 11 cases, on right coronary artery in 29 cases, on diagonal artery in 3 cases, on intermediate artery in 2 cases, on obtuse marginal artery in 5 cases. There was no hospital mortality in both groups. The intro-aortic balloon pump was required in 3 cases in Group A (3/38), which was more often than that in Group B (3/183). At the time of follow-up, coronary computed tomography angiogram showed all the grafts with CE were patent (50/50). There is no cardio-related mortality in both groups. All these patients were free from coronary re-intervention.
  
  
  CONCLUSIONS
  Coronary endarterectomy + CABG can offer satisfactory result for patients with diffused CAD in a short-term after the operation.
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Chi
authors.forename: Jian-Qun
authors.initials: JQ
authors.lastname: Zhang
authors.forename: Qing-Yu
authors.initials: QY
authors.lastname: Kong
authors.forename: Wei
authors.initials: W
authors.lastname: Xiao
authors.forename: Lin
authors.initials: L
authors.lastname: Liang
authors.forename: Xin-Liang
authors.initials: XL
authors.lastname: Chen
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D004691:Endarterectomy / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000601:surgery; D011183:Postoperative Complications; D016896:Treatment Outcome