In-Hospital Outcome of Patients Undergoing off-Pump Coronary Artery Bypass Graft With and Without Coronary Endarterectomy

Coronary endarterectomy (CE) can be used in patients with diffused coronary artery disease (CAD) as an adjunct technique to coronary artery bypass grafting (CABG) for complete revascularization. Because the impact of CE has been debated, hospital outcomes are of concern.
The aim of the current study is to compare hospital outcomes of patients undergoing off-pump CABG with and without CE.
We performed a retrospective analysis of data on patients undergoing CABG and CE between 2011 and 2012 by a single surgeon using off-pump technique. Patients were divided into CABG and CABG CE groups. Preoperative, perioperative, and postoperative data were collected from the data bank.
CABG was performed in 478 patients, of whom 69 had a CE. Hospital mortality was 0.7% in CABG and 0% in CABG CE group (P > 0.05). The duration of stay in the intensive care unit (ICU) was 37.23 ± 0.88 hours in the CABG group and 51.31 ± 5.59 hours in the CABG CE group (P = 0.015). Logistic regression confirms that CE is one of the factors affecting longer ICU stay. Blood transfusion was 324.71 ± 22 milliliters in the CABG group and 650.62 ± 110 milliliters in the CABG CE group (P = 0.001). There were no significant differences between myocardial infarction (MI) rate, arrhythmia, intra-aortic balloon pump insertion, or low cardiac output between the two groups.
The current study demonstrates that the results of CE are acceptable with respect to hospital outcome. CE as an adjunct to CABG offers a valuable surgical option for patients in whom complete revascularization cannot be obtained. With careful selection of patients, a well-judged and well-executed surgical technique, and good postoperative care, excellent results can be obtained.