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Belash S.A.

Research Institute- Ochapovsky Regional Clinical Hospital;
Kuban State Medical University

Barbukhatti K.O.

Research Institute- Ochapovsky Regional Clinical Hospital;
Kuban State Medical University

Shevchenko S.S.

Research Institute — Ochapovskiy Regional Clinical Hospital No. 1

Yasakova E.P.

Research Institute — Ochapovskiy Regional Clinical Hospital No. 1

Porkhanov V.A.

Research Institute — Ochapovsky Regional Clinical Hospital No. 1;
Kuban State Medical University

Long-term outcomes of coronary endarterectomy and prolonged segmental reconstruction in diffuse coronary atherosclerosis

Authors:

Belash S.A., Barbukhatti K.O., Shevchenko S.S., Yasakova E.P., Porkhanov V.A.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2020;13(5): 377‑384

DOI: 10.17116/kardio202013051377

Read: 1447 times

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Table of contents

LONG-TERM OUTCOMES OF CORONARY ENDARTERECTOMY AND PROLONGED SEGMENTAL RECONSTRUCTION IN DIFFUSE CORONARY ATHEROSCLEROSIS
LONG-TERM OUTCOMES OF CORONARY ENDARTERECTOMY AND PROLONGED SEGMENTAL RECONSTRUCTION IN DIFFUSE CORONARY ATHEROSCLEROSIS

To cite this article:

Belash SA, Barbukhatti KO, Shevchenko SS, Yasakova EP, Porkhanov VA. Long-term outcomes of coronary endarterectomy and prolonged segmental reconstruction in diffuse coronary atherosclerosis. Russian Journal of Cardiology and Cardiovascular Surgery. 2020;13(5):377‑384. (In Russ.)
https://doi.org/10.17116/kardio202013051377

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To assess long-term clinical and angiographic outcomes of extensive reconstructions of coronary arteries with or without endarterectomy.

MATERIAL AND METHODS

We retrospectively reviewed 1081 consecutive patients who underwent coronary artery bypass surgery with adjunct endarterectomy (n=421, CE group) or prolonged segmental reconstruction (n=660, no-CE group) in 2003-2016. Mean follow-up period was 94.3±31.2 months and included 88.4% (n=372) of patients in the CE group and 84.5% (n=558) of patients in the no-CE group (p=0.834).

RESULTS

Long-term survival was comparable in both groups — 81.6% (95% CI 78.1-86.2) vs. 83.2% (95% CI 74.5-89.3%) (p=0.531). No significant between-group differences in freedom from major adverse cardiovascular events (68.3±3.4 months in CE group vs. 64.7±4.1 months in no-CE group, p=0.462) and re-intervention rate (only PCI) (17.7% vs. 19.5%, p=0.276) were observed. Cardiovascular mortality was higher in the no-CE group (1.8% vs. 3.2%, p=0.032). Follow-up angiography was performed in 75.5% patients in the CE group and 66.6% of patients in the no-CE group (p=0.251). Long-term patency rate of the left internal mammary artery was better after extensive coronary reconstruction of the left descending coronary artery in the no-CE group compared to the CE group (95.2% vs. 87.5%, p<0.001). Patency of venous grafts was comparable in both groups — 72.9% vs. 75.4% (p=0.493).

CONCLUSION

Endarterectomy and prolonged segmental reconstruction without CE are comparable methods to reach complete revascularization for selected patients with diffuse atherosclerotic coronary lesion. Both techniques are characterized by excellent long-term survival and graft patency.

Keywords:

myocardial revascularization
coronary endarterectomy
prolonged segmental reconstruction of the coronary arteries
diffuse coronary artery disease
graft patency

Authors:

Belash S.A.

Research Institute- Ochapovsky Regional Clinical Hospital;
Kuban State Medical University

Barbukhatti K.O.

Research Institute- Ochapovsky Regional Clinical Hospital;
Kuban State Medical University

Shevchenko S.S.

Research Institute — Ochapovskiy Regional Clinical Hospital No. 1

Yasakova E.P.

Research Institute — Ochapovskiy Regional Clinical Hospital No. 1

Porkhanov V.A.

Research Institute — Ochapovsky Regional Clinical Hospital No. 1;
Kuban State Medical University

Received:

20.05.2020

Accepted:

15.06.2020

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