Full endarterectomy of Right coronary artery (RCA) and all
branches
Total endarterectomy of RCA
Mahdi Daliri 1, MD, Farshad
Shakerian1, MD, Sanaz Asadian1,MD,
Yaser Toloueitabar1, MD, Alireza Yaghoubi
Golverdi1 ,MD
1. Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran
Corresponding Author: Mahdi Daliri, Division of cardiac surgery, Hashemi
Rafsanjani HW, Rajaei hospital, Tehran, IRAN. Post code: 1995614331,
mobile No.: +989151040818, email: m_daliri@yahoo.com
words count: 361
Keywords: Right coronary artery, endarterectomy, CABG, CT Angio
Coronary endarterectomy (CEA) was proposed as a treatment strategy for
coronary diseases in the mid-20th century; however, as
a result of being complicated and unpredictable, it was not welcomed by
the physicians. The majority of surgeons do not use the procedure for
cases with diffuse or complete right coronary artery lesions. (1)
CEA is a sophisticated technique which should be applied only by
experienced surgeons, and in patients with diffuse coronary artery
diseases, in whom other options have not been effective. (2)
A 49-year-old male was admitted to the department with chest pain and
high creatinine. The patient underwent angiography; the results showed
total occlusion of RCA and significant stenosis of LAD and LCX. (Fig 1A)
Upon one session of dialysis, CABG was conducted for the patients.
Moreover, due to the diffuse calcification of the RCA and PDA, the total
CEA of RCA and its branches was conducted by a 5-mm incision on PDA.
(Fig 1B) One month later, the general condition of the patient was good,
and the CT-Angio showed the opening of RCA and its branches. . (Fig 1C)
Key clinical message
Full endarterectomy of right coronary artery (RCA) is an effective
treatment of total occlusion of RCA but the technique for full
extraction of plaque is more important.
Conflict of interest
The authors declare no conflict of interest.
Author contributions
DD and FS: contributed to acquisition of data, drafting the manuscript,
final revision of the manuscript, and participated sufficiently in the
work. SA, YT and AYG: contributed to acquisition of data, drafting the
manuscript, and participated sufficiently in the work.
Ethical approval
The report was performed in accordance with the ethical standards as
laid down in the 1964 Declaration of Helsinki and its later amendments
or comparable ethical standards. Also, it is in accordance with
institutional policies in this subject. Informed Consent: Written
informed consent has been obtained from the patient.
Funding information
No funding sources
Acknowledgements
Nothing to be mentioned
Availability of data and material
The datasets generated during the current report are available from the
corresponding author on reasonable request.
References:
Erdil N, Cetin L, Kucuker S, Demirkilic U, Sener E, Tatar H. Closed
endarterectomy for diffuse right coronary artery disease: early
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17(4):261-266.
Papakonstantinou NA, Baikoussis NG, Apostolakis E. Coronary
endarterectomy: new flavors from old recipes. J Cardiol . 2014;
63(6):397-401.
Figure legend: Fig 1: Full endarterectomy of right coronary artery
(RCA). 1A: Total occlusion of RCA in angiography. 1B: Image of long and
total plaque of RCA and it’s all branches. 1C: CT angiography view of
patent RCA and other grafts after one month after surgery