coronary endarterectomy: technique and results in a case-control study endarterectomia de artérias coronárias: técnicas e resultados em estudo com grupo controle

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ID: 226807
2003
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Ranked #39 of 103 articles by views in 2017 international conference on information technology systems and innovation, icitsi 2017 - proceedings

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Abstract
OBJECTIVE: Early reports showed a high incidence of postoperative morbidity and mortality after coronary endarterectomy, and its value is still controversial. With technical improvement the role of coronary endarterectomy has been reviewed. In this study we evaluate our results of coronary endarterectomy, and show our strategy for patients with diffuse coronary artery disease. METHOD: We retrospectively reviewed 278 patients who underwent coronary artery bypass grafting, between January 2000 and December 2001, separated in two groups. The endarterectomy group - 32 patients (11.5%) who underwent coronary endarterectomy and the control group of patients characteristics similar to the first group. RESULTS: The mean follow-up time was 9.9 months. Both groups only demonstrated a statistical difference in the number of previous myocardial infarctions. The coronary endarterectomy was performed on 38 vessels, 78.75% in the left coronary system, and 21.05% in the right system. In the postoperative follow-up no significant differences were detected, but in the coronary endarterectomy group the incidence of intra-aortic balloon pump insertion was higher. CONCLUSIONS: We demonstrated that coronary endarterectomy should be used to achieve complete revascularization in patients with diffuse coronary disease, and the results are similar to conventional surgical treatment. A long-term follow up is necessary to demonstrate the future performance of these vessels and grafts.
OBJETIVO: Os resultados descritos das endarterectomias de artérias coronárias (EAC) refletiam as experiências iniciais e demonstravam uma maior morbidade pós-operatória e mortalidade imediata, tornando seu valor controverso. Com o aprimoramento técnico, o papel da EAC vem sendo revisto. O presente estudo tem como objetivo avaliar os nossos resultados com a EAC e apresentar a nossa conduta frente aos pacientes com doença coronariana difusa. MÉTODO: De um total de 278 pacientes submetidos a revascularização isolada, entre janeiro de 2000 e dezembro de 2001, 32 (11,5%) foram endarterectomizados formando o grupo EAC. O grupo controle foi formado por pacientes com características semelhantes a cada paciente do primeiro grupo. RESULTADOS: O tempo médio de acompanhamento foi de 9,9 meses. Os dois grupos demonstraram diferença estatística quanto ao número de infartos prévios. Foram realizadas 38 endarterectomias, 78,75% nos ramos coronarianos esquerdos e 21,05% nos ramos coronarianos direitos. No acompanhamento pós-operatório, não se encontrou diferença significativa entre as variáveis estudadas de morbi-mortalidade, embora uma maior utilização de balão intra-aórtico no grupo EAC tenha sido observada. CONCLUSÕES: Demonstrou-se que a EAC deve ser aplicada aos pacientes com doença coronariana difusa, visando uma revascularização miocárdica completa, com resultados comparáveis aos pacientes submetidos a operação convencional. O acompanhamento em longo prazo irá determinar o comportamento destas artérias e de seus enxertos.
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Authors ;André Luiz Tyska;Maria Marta de Carvalho Cabral;Ederval Key Hayashi;Geraldo Ângelo Nogueira;Marcos Borges Machado;Leonardo Monteiro de Castro Machado;Armando Progiante;Leila Satomi Fucuda;Raul D'Áurea Mora
Journal 2017 international conference on information technology systems and innovation, icitsi 2017 - proceedings
Year 2003
DOI
10.1590/S0102-76382003000100010
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382003000100010
Keywords
coronary disease myocardial revascularization endarterectomysurgerydiseases of the circulatory (cardiovascular) system

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