Early Clinical Outcomes and Mortality of Coronary Endarterectomy in the Left Anterior Descending Artery: A Single-Center Experience

Introduction: Although coronary endarterectomy is not an ideal procedure, it is the only available option for cardiac surgeons in some patients with diffuse coronary artery disease. Based on the majority of conducted studies, the results of coronary endarterectomy (including survival, graft patency, and recurrence of the symptoms of myocardial ischemia) are less prevalent than standard coronary artery bypass grafting. Generally, the left anterior descending artery (LAD) is the most commonly involved artery in coronary endarterectomy. The aim of this study was evaluate clinical and early results of Endarterectomy of LAD artery. Materials and Methods: In total, 30 cases of coronary endarterectomy of the LAD were studied from January 2015 until January 2016.This is a retrospective study. Endarterectomy procedure was performed in Imamreza hospital of Mashhad university of medical sciences. Results: The mean age of the subjects was 63±4.5 years (range: 45-78 years). As the findings revealed, 18 patients were male (60%), and the mean ejection fraction index was 43±5.1 (range: 15-60). Also, prior history of myocardial infarction was documented in 8 (26%) patients. The mortality rate among patients was estimated at 6.6% (n=2). In total, 12 (40%) and 7 (23%) patients required high-dose inotropic support and intra-aortic balloon pump, respectively. Risk of preoperative myocardial infarction was observed in 5 (16.5%) cases, and 3 (10%) patients required re-exploration due to significant hemorrhage. Conclusion: If coronary endarterectomy of the LAD is performed by experienced cardiac surgeons, favorable outcomes can be obtained.