Long-term survival from 801 adjunctive coronary endarterectomies in diffuse coronary artery disease

Priyadharshanan Ariyaratnama, Kalyana Javangulab, Sotiris Papaspyrosb, Evie McCrum-Gardner, Ramanpillai Unnikrishanan Nair

    Research output: Contribution to journalArticle

    9 Citations (Scopus)

    Abstract

    OBJECTIVES: The role of coronary endarterectomy (CE) in modern cardiac surgery has been an extant debate as coronary arterybypass grafting (CABG) has advanced. However, as cardiac surgeons are being referred ever more complex coronary disease for surgicalcorrection, adjunctive strategies may need re-evaluation. The long-term results of CE are largely unknown. We present the longestcohort follow-up in a single institution looking at our 20-year experience of CEs employed as an adjunct to CABG in diffuse coronaryartery disease.METHODS: We performed retrospective analysis of data collected prospectively on 801 patients undergoing CEs between February1988 and September 2010 by a single surgeon using a standard open hydrodissection technique. We looked at patient demographics,characteristics of the vessels subjected to endarterectomy and predictors of long-term survival within this surgical group using Cox’sregression analysis.RESULTS: The mean age was 63.2 (±9.6) years. The mean number of coronary arteries undergoing endarterectomy was 1.16 (±0.4) perpatient. Of these, 63.7% were performed on the right coronary artery (n = 558) and 32.3% on the left anterior descending artery(n = 283). The operative mortality was 2.62% (n = 21). The median survival time was 16.67 years (95% confidence interval 15.14–18.19years). The significant predictors of survival (P <0.05) were a lower age at surgery, a lower EuroSCORE I, the absence of peripheralvascular disease and shorter bypass times.CONCLUSION: This significant long-term survival demonstrates that CE can be an attractive adjunct to CABG in otherwise inoperablecoronary artery disease.Keywords: Coronary artery bypass grafting surgery • Endarterectomy
    LanguageEnglish
    Pages1-6
    JournalEuropean Journal of Cardio-Thoracic Surgery
    Volume0
    DOIs
    Publication statusPublished - 13 Aug 2012

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    Endarterectomy
    Coronary Artery Disease
    Survival
    Coronary Artery Bypass
    Coronary Vessels
    Arteries
    Thoracic Surgery
    Coronary Disease
    Demography
    Confidence Intervals
    Mortality

    Cite this

    Ariyaratnama, Priyadharshanan ; Javangulab, Kalyana ; Papaspyrosb, Sotiris ; McCrum-Gardner, Evie ; Nair, Ramanpillai Unnikrishanan. / Long-term survival from 801 adjunctive coronary endarterectomies in diffuse coronary artery disease. In: European Journal of Cardio-Thoracic Surgery. 2012 ; Vol. 0. pp. 1-6.
    @article{4a6f5849aa46491b98789be4eae20a4f,
    title = "Long-term survival from 801 adjunctive coronary endarterectomies in diffuse coronary artery disease",
    abstract = "OBJECTIVES: The role of coronary endarterectomy (CE) in modern cardiac surgery has been an extant debate as coronary arterybypass grafting (CABG) has advanced. However, as cardiac surgeons are being referred ever more complex coronary disease for surgicalcorrection, adjunctive strategies may need re-evaluation. The long-term results of CE are largely unknown. We present the longestcohort follow-up in a single institution looking at our 20-year experience of CEs employed as an adjunct to CABG in diffuse coronaryartery disease.METHODS: We performed retrospective analysis of data collected prospectively on 801 patients undergoing CEs between February1988 and September 2010 by a single surgeon using a standard open hydrodissection technique. We looked at patient demographics,characteristics of the vessels subjected to endarterectomy and predictors of long-term survival within this surgical group using Cox’sregression analysis.RESULTS: The mean age was 63.2 (±9.6) years. The mean number of coronary arteries undergoing endarterectomy was 1.16 (±0.4) perpatient. Of these, 63.7{\%} were performed on the right coronary artery (n = 558) and 32.3{\%} on the left anterior descending artery(n = 283). The operative mortality was 2.62{\%} (n = 21). The median survival time was 16.67 years (95{\%} confidence interval 15.14–18.19years). The significant predictors of survival (P <0.05) were a lower age at surgery, a lower EuroSCORE I, the absence of peripheralvascular disease and shorter bypass times.CONCLUSION: This significant long-term survival demonstrates that CE can be an attractive adjunct to CABG in otherwise inoperablecoronary artery disease.Keywords: Coronary artery bypass grafting surgery • Endarterectomy",
    author = "Priyadharshanan Ariyaratnama and Kalyana Javangulab and Sotiris Papaspyrosb and Evie McCrum-Gardner and Nair, {Ramanpillai Unnikrishanan}",
    year = "2012",
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    doi = "10.1093/ejcts/ezs510",
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    Long-term survival from 801 adjunctive coronary endarterectomies in diffuse coronary artery disease. / Ariyaratnama, Priyadharshanan; Javangulab, Kalyana; Papaspyrosb, Sotiris; McCrum-Gardner, Evie; Nair, Ramanpillai Unnikrishanan.

    In: European Journal of Cardio-Thoracic Surgery, Vol. 0, 13.08.2012, p. 1-6.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Long-term survival from 801 adjunctive coronary endarterectomies in diffuse coronary artery disease

    AU - Ariyaratnama, Priyadharshanan

    AU - Javangulab, Kalyana

    AU - Papaspyrosb, Sotiris

    AU - McCrum-Gardner, Evie

    AU - Nair, Ramanpillai Unnikrishanan

    PY - 2012/8/13

    Y1 - 2012/8/13

    N2 - OBJECTIVES: The role of coronary endarterectomy (CE) in modern cardiac surgery has been an extant debate as coronary arterybypass grafting (CABG) has advanced. However, as cardiac surgeons are being referred ever more complex coronary disease for surgicalcorrection, adjunctive strategies may need re-evaluation. The long-term results of CE are largely unknown. We present the longestcohort follow-up in a single institution looking at our 20-year experience of CEs employed as an adjunct to CABG in diffuse coronaryartery disease.METHODS: We performed retrospective analysis of data collected prospectively on 801 patients undergoing CEs between February1988 and September 2010 by a single surgeon using a standard open hydrodissection technique. We looked at patient demographics,characteristics of the vessels subjected to endarterectomy and predictors of long-term survival within this surgical group using Cox’sregression analysis.RESULTS: The mean age was 63.2 (±9.6) years. The mean number of coronary arteries undergoing endarterectomy was 1.16 (±0.4) perpatient. Of these, 63.7% were performed on the right coronary artery (n = 558) and 32.3% on the left anterior descending artery(n = 283). The operative mortality was 2.62% (n = 21). The median survival time was 16.67 years (95% confidence interval 15.14–18.19years). The significant predictors of survival (P <0.05) were a lower age at surgery, a lower EuroSCORE I, the absence of peripheralvascular disease and shorter bypass times.CONCLUSION: This significant long-term survival demonstrates that CE can be an attractive adjunct to CABG in otherwise inoperablecoronary artery disease.Keywords: Coronary artery bypass grafting surgery • Endarterectomy

    AB - OBJECTIVES: The role of coronary endarterectomy (CE) in modern cardiac surgery has been an extant debate as coronary arterybypass grafting (CABG) has advanced. However, as cardiac surgeons are being referred ever more complex coronary disease for surgicalcorrection, adjunctive strategies may need re-evaluation. The long-term results of CE are largely unknown. We present the longestcohort follow-up in a single institution looking at our 20-year experience of CEs employed as an adjunct to CABG in diffuse coronaryartery disease.METHODS: We performed retrospective analysis of data collected prospectively on 801 patients undergoing CEs between February1988 and September 2010 by a single surgeon using a standard open hydrodissection technique. We looked at patient demographics,characteristics of the vessels subjected to endarterectomy and predictors of long-term survival within this surgical group using Cox’sregression analysis.RESULTS: The mean age was 63.2 (±9.6) years. The mean number of coronary arteries undergoing endarterectomy was 1.16 (±0.4) perpatient. Of these, 63.7% were performed on the right coronary artery (n = 558) and 32.3% on the left anterior descending artery(n = 283). The operative mortality was 2.62% (n = 21). The median survival time was 16.67 years (95% confidence interval 15.14–18.19years). The significant predictors of survival (P <0.05) were a lower age at surgery, a lower EuroSCORE I, the absence of peripheralvascular disease and shorter bypass times.CONCLUSION: This significant long-term survival demonstrates that CE can be an attractive adjunct to CABG in otherwise inoperablecoronary artery disease.Keywords: Coronary artery bypass grafting surgery • Endarterectomy

    U2 - 10.1093/ejcts/ezs510

    DO - 10.1093/ejcts/ezs510

    M3 - Article

    VL - 0

    SP - 1

    EP - 6

    JO - European Journal of Cardio-Thoracic Surgery

    T2 - European Journal of Cardio-Thoracic Surgery

    JF - European Journal of Cardio-Thoracic Surgery

    SN - 1010-7940

    ER -