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Coronary Endarterectomy: Analysis of The Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Publication ,  Conference
Kelly, JJ; Han, JJ; Desai, ND; Iyengar, A; Acker, AM; Grau-Sepulveda, M; Zwischenberger, BA; Jawitz, OK; Hargrove, WC; Szeto, WY; Williams, ML
Published in: Ann Thorac Surg
September 2022

BACKGROUND: Coronary endarterectomy (CE) is an uncommon and often unplanned technique used to approach difficult targets during coronary artery bypass grafting (CABG). We evaluated the outcomes of CABG with CE (CE-CABG) using The Society of Thoracic Surgeons Adult Cardiac Surgery Database. METHODS: All isolated, first-time, elective or urgent CABG cases from July 2011 to September 2019 in the Adult Cardiac Surgery Database were retrospectively reviewed. Because of a higher risk profile in the patients undergoing CE-CABG, we performed propensity score matching. Primary outcomes included operative mortality and postoperative myocardial infarction. For patients ≥65 years, long-term mortality and rehospitalization were evaluated using linked data from Centers for Medicare and Medicaid Services. RESULTS: Of the total 1 111 792 patients included, 32 164 (2.9%) had CE-CABG and 1 079 628 (97.1%) underwent CABG alone. The majority of CE-CABG involved a single-vessel endarterectomy (86.9%; n = 27 945); the left anterior descending was most common (40.9%; n = 13 161). Compared with propensity score-matched CABG, CE-CABG had increased operative mortality (3.2% vs 1.7%; P < .0001; odds ratio, 1.81; 95% CI, 1.63-2.01) and postoperative myocardial infarction (6.8% vs 3.9%; P < .0001; odds ratio, 1.80; 95% CI, 1.68-1.93). CE-CABG had higher risk of mortality in the first year and rehospitalization for myocardial infarction in the first 3 years but was comparable to CABG alone thereafter. Subgroup analysis showed no difference between CE-CABG of the left anterior descending compared with CE-CABG of other coronary arteries. CONCLUSIONS: This analysis demonstrates that CE-CABG has acceptable long-term outcomes and serves as a benchmark for what can be expected when this rare procedure is used.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

September 2022

Volume

114

Issue

3

Start / End Page

667 / 674

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgeons
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Myocardial Infarction
  • Medicare
  • Humans
  • Endarterectomy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kelly, J. J., Han, J. J., Desai, N. D., Iyengar, A., Acker, A. M., Grau-Sepulveda, M., … Williams, M. L. (2022). Coronary Endarterectomy: Analysis of The Society of Thoracic Surgeons Adult Cardiac Surgery Database. In Ann Thorac Surg (Vol. 114, pp. 667–674). Netherlands. https://doi.org/10.1016/j.athoracsur.2022.01.067
Kelly, John J., Jason J. Han, Nimesh D. Desai, Amit Iyengar, Andrew M. Acker, Maria Grau-Sepulveda, Brittany A. Zwischenberger, et al. “Coronary Endarterectomy: Analysis of The Society of Thoracic Surgeons Adult Cardiac Surgery Database.” In Ann Thorac Surg, 114:667–74, 2022. https://doi.org/10.1016/j.athoracsur.2022.01.067.
Kelly JJ, Han JJ, Desai ND, Iyengar A, Acker AM, Grau-Sepulveda M, et al. Coronary Endarterectomy: Analysis of The Society of Thoracic Surgeons Adult Cardiac Surgery Database. In: Ann Thorac Surg. 2022. p. 667–74.
Kelly, John J., et al. “Coronary Endarterectomy: Analysis of The Society of Thoracic Surgeons Adult Cardiac Surgery Database.Ann Thorac Surg, vol. 114, no. 3, 2022, pp. 667–74. Pubmed, doi:10.1016/j.athoracsur.2022.01.067.
Kelly JJ, Han JJ, Desai ND, Iyengar A, Acker AM, Grau-Sepulveda M, Zwischenberger BA, Jawitz OK, Hargrove WC, Szeto WY, Williams ML. Coronary Endarterectomy: Analysis of The Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg. 2022. p. 667–674.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

September 2022

Volume

114

Issue

3

Start / End Page

667 / 674

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgeons
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Myocardial Infarction
  • Medicare
  • Humans
  • Endarterectomy