Author/Editor		Radovanović, Ninoslav; Nicin, S; Petrović, Lj; Jonjev, Z; Selestiansky, J; Fabri, M; Mihajlović, B; Mijatov, M
Title		Coronary endarterectomy
Type		članek
Source		In: Pajer Z, Štiblar-Martinčič D, editors. International symposium on cardiovascular diseases. Proceedings of the 29th memorial meeting devoted to prof. dr. Janez Plečnik; 1998 Dec 3-5; Ljubljana. Ljubljana: Medical faculty, Institute of histology and embryology,
Publication year		1998
Volume		str. 113-28
Language		eng
Abstract		Surgical treatment of diffuse and distal coronary disease is still controversial and represents clinical, cardiologic and surgical problem. In many centers, poor distal coronary bed is acontraindication for myocardial revascularisation and these patients are at the waiting list for heart transplantation. According to our experience with 3019 operated patients, endarterectomy of coronary arteries enables a new change for helping this group of patients and extends indications for myocardial revascularisation. Out of the total number of 9108 patients who had undergone myocardial revascularisation, 3019 (33.1%) had an additional endarterectomy (EA) on one or several coronary vessles. Postoperative mortality 0 30 days (PM) was 5.2%. Our technique is closed and manual EA. We use extensive EA, as the complementary procedure for direct myocardial revascularisation with bypass grafting. However, total EA is EA of the whole coronary artery, and this is the new effective possibility for direct myocardial revascularisation with patch reconstruction of coronary artery and without by-pass grafting (CABG). In 1988 we introduced prostacyclin as like "bridge to heparinisation", based on the useful effect in prevention of early thrombosis in microcirculation during and after cardiopulmonary by-pass and EA. Endarterectomy is most often performed in re-do coronary surgery - 54% in our series, in patients with ejection fraction (EF) lower than 30% - 54% and in patients with EF<20% - 57%. We dedicate special attention to the EA of the first septal coronary artery. In this group of 553 (18.3%) high risk pts PM was 8.6%. Early recoronarograph has shown good patency of grafts. Most patients are free of angina and have an improved tolerance of effort.(Abstract truncated at 2000 characters)
Descriptors		CORONARY DISEASE ENDARTERECTOMY CORONARY ANGIOGRAPHY MYOCARDIAL REPERFUSION