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Does Coronary Endarterectomy in the Left Anterior Descending Artery Increase Surgical Morbidity and Mortality?

Author(s): Hasan Reyhanoglu, Kaan Ozcan

Background: In this study, we investigated the effect of adjuvant coronary endarterectomy in the left anterior descending (LAD) artery on mortality and morbidity in subjects that underwent coronary artery bypass graft (CABG) surgery.

Methods: A total of 140 patients that underwent coronary endarterectomy (CE), performed as an adjuvant to CABG between November 2010 and November 2019, were assigned to one of two groups and examined. Early postoperative outcomes were compared between 30 patients that underwent CE in the LAD (LAD group) and 110 patients that underwent CE in the right and circumflex coronary arteries (non-LAD group).

Results: Atrial fibrillation, renal failure, and re-exploration due to bleeding were more frequent in the LAD group during the early postoperative period. The incidence of postoperative complications in the LAD group (56.7%) and in the non-LAD group (29.1%) were statistically significant (p=0.010). The mortality was 13.3% in the LAD group and 4.5% in the non-LAD group, although no statistically significant difference was found between the groups (p=0.099).

Conclusion: The subjects that underwent CABG and simultaneous LAD endarterectomy may have had higher rates morbidity and mortality due to the presence of a complex vascular structure and additional comorbid factors.

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