title: Coronary endarterectomy in left anterior descending artery combined with coronary artery bypass grafting - midterm mortality and morbidity.
abstract: BACKGROUND
  Completeness of myocardial revascularization is essential in surgical treatment of coronary artery disease. The aim of this study is to determine the effectiveness of coronary endarterectomy as an adjunct to coronary artery bypass grafting (CABG) in the most difficult cases.
  
  
  METHODS
  Among 1559 patients who had CABG in our department, the cases of 17 who underwent an adjunct left anterior descending endarterectomy were analyzed. All procedures were performed with median sternotomy, extracorporeal circulation and in mild hypothermia (34°C), by the same surgeon. No coronary artery endarterectomy was planned before surgery.
  
  
  RESULTS
  There was no infarction or cardiac arrest during hospitalization. Only one patient required mechanical circulatory support (intra-aortic balloon counterpulsation). Each patient was contacted and investigation for major adverse cardiac and cerebrovascular events (MACCE) was performed. Eleven patients (65%) already underwent midterm clinical evaluation. There was no death, myocardial infarction or cerebrovascular incident during the entire period (mean follow-up at 15.3 months). One patient required urgent coronarography due to chest pain. No other patient had chest pain or significant deterioration of ventricular function in echocardiography.
  
  
  CONCLUSIONS
  Outcomes and potential indications for performing left anterior descending coronary endarterectomy as an adjunct to CABG are discussed.
authors: American Heart of Poland, First Department of Cardiac Surgery, Bielsko-Biała, Poland.
authors: Wojciech
authors: W
authors: Domaradzki
authors: American Heart of Poland, First Department of Cardiac Surgery, Bielsko-Biała, Poland.
authors: Krzysztof
authors: K
authors: Sanetra
authors: American Heart of Poland, First Department of Cardiac Surgery, Bielsko-Biała, Poland.
authors: Jolanta
authors: J
authors: Krauze
authors: American Heart of Poland, Second Department of Cardiology, Bielsko-Biała, Poland.
authors: Leszek
authors: L
authors: Kinasz
authors: American Heart of Poland, Second Department of Cardiology, Bielsko-Biała, Poland.
authors: Justyna
authors: J
authors: Jankowska-Sanetra
authors: American Heart of Poland, First Department of Cardiac Surgery, Bielsko-Biała, Poland.
authors: Małgorzata
authors: M
authors: Świątkiewicz
authors: American Heart of Poland, Department of Anaesthesiology and Intensive Care, Bielsko-Biała, Poland.
authors: Krzysztof
authors: K
authors: Paradowski
authors: American Heart of Poland, First Department of Cardiac Surgery, Bielsko-Biała, Poland.
authors: Marek
authors: M
authors: Cisowski
keywords: CABG; CE; coronary artery disease; endarterectomy