Reference : Usefulness of Thromboendarterectomy in Association with Coronary Artery Bypass Grafting
Scientific journals : Article
Human health sciences : Surgery
Human health sciences : Cardiovascular & respiratory systems
Usefulness of Thromboendarterectomy in Association with Coronary Artery Bypass Grafting
Larock, Marie-Paule [> > > >]
Burguet, Willy []
Grenade, Thierry []
Trotteur, Geneviève mailto [Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine) >]
MAGOTTEAUX, Paul mailto [Centre Hospitalier Universitaire de Liège - CHU > > Imagerie thoracique et cardio-vasculaire >]
Limet, Raymond mailto [Université de Liège - ULiège > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique]
Rigo, Pierre mailto [Université de Liège - ULiège > Département des sciences de la motricité > Pathologie générale et médecine nucléaire >]
American Journal of Cardiology
Elsevier Science
Yes (verified by ORBi)
New York
[en] Thromboendarterectomy is sometimes performed in association with coronary artery bypass graft surgery (CABG). Right coronary arteries and severely narrowed coronary arteries mainly undergo thromboendarterectomy, but perioperative acute myocardial infarctions (AMI) are possible complications. One hundred seventy-six consecutive patients with rest and stress thallium-201 scintigraphy and angiography were studied before and after surgery. To compare patients with and without thromboendarterectomy, 48 patients who had undergone thromboendarterectomy and whose characteristics matched closely those of patients who had not were selected. Twenty patients had previous AMI before CABG in each group. Analysis accounted for the severity of vessel lesion (complete or incomplete) and for the patency of the graft and of the native coronary artery. In these 96 patients, graft patency was lower than in the overall group and similar among patients with and without thromboendarterectomy among the 56 patients without previous AMI. In patients with previous AMI and thromboendarterectomy, however, reperfusion was achieved more often through the native vessel than through the graft. New AMI or residual ischemia occurred in 32% of the areas undergoing thromboendarterectomy and in only 5% of the standard grafts (p less than 0.001). Best results were obtained in patients with incomplete occlusion after AMI. Patients without previous AMI had worse results. Thus, thromboendarterectomy can yield 64 to 75% good results in selected subgroups when CABG is otherwise impossible, but should be avoided in mildly or moderately stenotic arteries perfusing noninfarcted myocardium.
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