Comparative Outcomes of Closed RCA Endarterectomy and Open LAD Endarterectomy with LIMA Patch Plasty

Murat Tavlasoglu 1 2 * , Mehmet Arslan 3
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1 Department of Cardiovascular Surgery Private Buhara Hospital, Erzurum, Turkey
2 Department of Cardiovascular Surgery, Misrata Heart and Cardiovascular Center, Misrata, Libya
3 Department of Cardiovascular Surgery, Private Kavaklidere Umut Hospital, Ankara, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 23, Issue 4, pp. 60-65. https://doi.org/10.23950/jcmk/18886
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Author Contributions: M.T. collected data, made analysis and wrote manuscript, M.A. supervised the retrospective study. All authors have read and approved the final version of the manuscript.

Data availability statement: The data that support the findings of this study are not publicly available due to [confidentiality/privacy] restrictions but are available from the corresponding author upon reasonable request.

Artificial Intelligence (AI) Disclosure Statement: No artificial intelligence tools were used in the design, data analysis, or interpretation of this study. Artificial Intelicence were used only for language editing if needed.

Consent for publication: All data were fully anonymized, and no individual patient-identifiable information was included in this study.

ABSTRACT

Introduction: Coronary endarterectomy (CE) is an adjunctive technique used to achieve complete revascularization in patients with diffuse coronary artery disease when conventional bypass grafting is not feasible. To compare early outcomes and graft patency between closed right coronary artery (RCA) endarterectomy and open left anterior descending (LAD) endarterectomy with left internal mammary artery (LIMA) patch plasty.
Methods: This retrospective study included 31 patients undergoing closed traction RCA endarterectomy and 36 patients undergoing open LAD endarterectomy with LIMA patch plasty during CABG. Perioperative outcomes, postoperative arrhythmias, and follow-up coronary angiographic findings were analyzed.
Results: Early mortality occurred only in the closed RCA group but was not statistically significant. Atrial fibrillation rates were similar. The closed RCA group demonstrated significantly higher postoperative bleeding, greater inotropic and intra-aortic balloon pump requirements, longer ICU stay, and more frequent ventricular arrhythmias. Follow-up angiography at a mean of 6.08 ± 2.01 years (open LAD) and 4.21 ± 1.12 years (closed RCA) showed significantly higher anastomotic patency in the open LAD group (94.1% vs. 50.0%, p = 0.008).
Conclusion: Open LAD endarterectomy with LIMA patch plasty provides a more stable early postoperative course and superior mid-term graft patency compared with closed RCA endarterectomy.
Keywords: Coronary endarterectomy, Right coronary artery, Left anterior descending artery, LIMA patch plasty, Coronary artery bypass grafting

CITATION

Tavlasoglu M, Arslan M. Comparative Outcomes of Closed RCA Endarterectomy and Open LAD Endarterectomy with LIMA Patch Plasty. J CLIN MED KAZ. 2026;23(4):60-5. https://doi.org/10.23950/jcmk/18886

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