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Coronary Endarterectomy On Beating Heart Feasibility And Experience

Coronary Endarterectomy On Beating Heart Feasibility And Experience. Vijay Dikshit, Sanjay Kumar, Sanjeev Khulbey, Apollo Hospitals, Hyderabad. Introduction. Coronary endarterectomy continues to be a controversial technique Endarterectomy is considered to be an impediment for Off Pump CABG

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Coronary Endarterectomy On Beating Heart Feasibility And Experience

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  1. Coronary Endarterectomy On Beating Heart Feasibility And Experience Vijay Dikshit, Sanjay Kumar, Sanjeev Khulbey, Apollo Hospitals, Hyderabad

  2. Introduction • Coronary endarterectomy continues to be a controversial technique • Endarterectomy is considered to be an impediment for Off Pump CABG • With some technical modification endarterectomy is possible for most coronary branches with Off Pump CABG.

  3. Off Pump Endartrectomy Of Individual Coronary Branches

  4. Off Pump Cx (OM) Endarterectomy

  5. Technique of Off Pump Coronary Endarterectomy RCA &Cx • Closed technique - Large arteriotomy - Plaque dissection -`Push’ on distal artery LAD • Open technique - Long patch arterioplasty using IMA & SVG

  6. Technical difficulty • Exposure and stabilisation of long segment of coronary arteries • Haemostasis • Non availability of long shunts and occluder

  7. Antiplatelet protocol • Clopidogril 150 mg in the immediate post operative period • Aspirin + Clopidogril from 1st POD

  8. Conclusion • Need for endarterectomy is not an indication for conversion to cardiopulmonary bypass • With little technical modifications endarterectomy of most coronary branches can be safely done with off pump technique

  9. Thank You

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