Proximal Endarterectomy, Arterial Reconstruction for Coronary Occlusion at Aortic Origin

Abstract

THE DEVELOPMENT of coronary arteriography during the past decade has greatly expanded the ability to establish an accurate diagnosis of coronary arterial obstruction. Radiographic visualization of the coronary arteries provides an objective method for establishing the site and magnitude of vascular occlusion, and with increased experience the procedure has become both reliable and safe.^1-3 As a result of the information gained by this technique, a number of patients have now been operated upon successfully for the direct relief of a variety of coronary arterial lesions. Coronary atherosclerosis most frequently attacks the proximal portions of the coronary vessels, a fact which has been repeatedly documented by a number of pathological studies. In most instances the lesions involve the first several centimeters of the coronary arteries. However, in the recent past it has been noted that coronary atherosclerosis may be sharply localized to the first several millimeters of a coronary artery