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Ann Thorac Surg 1981;31:28-35
© 1981 The Society of Thoracic Surgeons

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Articles

Patency and Flow Response in Endarterectomized Coronary Arteries

From the University of Wisconsin-Mount Sinai Medical Center, Milwaukee, WI

^* Address reprint requests to Dr. Kamath, 3112 W Highland Blvd, Milwaukee, WI 53208

Ninety patients, operated on from May, 1978, through June, 1979, underwent coronary endarterectomy and early recatheterization. Patency of grafts to endarterectomized arteries was 103 of 118 (87.3%) and patency of conventional vein grafts in the same patients was 217 of 233 (93.1%). Myocardial blood flow using xenon 133 washout, at rest and with isoproterenol-induced stress, was measured in 7 normal coronary arteries, 28 conventional saphenous vein grafts, and 33 saphenous vein grafts to endarterectomized coronary arteries. The increase in myocardial blood flow, from rest to isoproterenol-induced stress, was comparable for the three groups. The endarterectomized group was divided further by separating out the 10 patients with heavy scarring or residual disease. The remaining patients had a flow response identical to those with conventional saphenous vein grafts. The rate of perioperative infarction in patients receiving endarterectomy was 3 of 113 (2.6%), as measured by appearance of new persistent Q waves on the serial postoperative electrocardiogram. Positive pyrophosphate scans were noted in 13 of 105 (12.4%) patients.

It is concluded that, in the early stages at least, grafts to endarterectomized coronary arteries stay open and perfuse the myocardium as well as conventional saphenous vein grafts unless the myocardium is heavily scarred or unless residual disease remains.

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