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  • Surgical treatment of diffuse and distal coronary diseases - coronary endarterectomy
    Radovanović, Ninoslav ...
    Material and methods: Out of the total number of 10620 patients who had undergone myocardial revascularisation, 3267 (31%) had an additional endarterectomy (E) on one or several coronary vessels. Our ... technique is closedand manual E. We use extensive E, as the complementary procedure for direct myocardial revascularisation with bypass grafting. However, total E is E 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 Prostacyclinas a "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 - 55% in our series, in patients with ejection fraction(EF) lower than 30% - 52% and patients with EF<20% - 55%. Results: Postoperative mortality - 30 days (PM) was 4.9% (162/3267). We dedicate special attention to the EA of the first septal coronary artery. In this groupof 560 (17.3%) high risk pts PM was 8.6%. Early recoronarography has shown good patency of grafts. Most patients are free of angina and have an improved tolerance of effort. Long-term results, show that the survival rate is over 90% with SE+-3.0%, infarction-free rate in 87% (SE+-2.0%) and angina-free rate is over 95% (SE+-3.0%), at five years and over 75%, 80%, 75%at 10 years respectively. Conclusions: Thanks to use of EA we can successfully operate patients in end-stage coronary arteries disease. Extensive or total EA is the best procedure for revascularisation of the septum. (Abstract truncated at 2000 characters).
    Vir: Cardiovascular diseases : proceedings of the 32nd Memorial Meeting Devoted to Professor Janez Plečnik (Str. 227-234)
    Vrsta gradiva - prispevek na konferenci
    Leto - 2001
    Jezik - angleški
    COBISS.SI-ID - 14192089

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