OUTCOME OF CORONARY ENDARTECTOMY OF THE LEFT ANTERIOR DESCENDING ARTERY: OPEN VERSUS CLOSED TECHNIQUE. COMPARISON AT A TERTIARY CARDIAC CARE FACILITY

Abstract

Objective: To compare the outcome of Coronary Artery Bypass Graft surgery (CABG) after Coronory Endartectomy (CE) of the Left Anterior Descending Artery (LAD) using the open technique with that employing the closed technique.

Study Design: Reterospective Comparative cross sectional study.

Place and Duration of Study: Department of Adult Cardiac surgery of Armed Forces institute of Cardiology, Rawalpindi, from September 2011 to June 2015.

Material and Methods: Total 52 patients with diffuse atheromatous disease of the LAD who underwent CABG surgery necessitating CE of the LAD were investigated retrospectively. These were divided into 2 groups on the basis of technique of CE utilized: Group (Gp) I underwent open CE of the LAD and GpII had closed CE. All patients were followed up for evaluation of peri-operative mortality and morbidity and freedom from recurrent
angina, myocardial infarction (MI) and death at 18 months.

Results: There was no peri-operative mortality in group I whereas there were two (7.69%) early deaths in Group II. One patient (3.84%) in Gp I had a non-fatal peri-operative MI as compared to two (7.69%) in Gp II. At 18 months follow-up there was no late death or fresh MI in either group. Two patients (7.69%) in Gp II and none in Gp I had recurrent angina.

Conclusion: We conclude from this study that both the open and closed techniques of CE and equally safe in the short and medium- term after CABG surgery in a sub-group of patients with diffuse CAD who are otherwise at a high risk of fatal outcome if left untreated.