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Role of Endarterectomy : Endarterectomy is done as a semi open technique. 5-10mm long incision is made on the outer layers of the coronary artery and plain developed in 11ic thickened media of the vessel. By gentle dissection arid traction, the plane is extended display and a tapering specimen with branches is removed as a single piece. Ti' the specimen breaks off, the arteriotomy is extended and attempt is made to I remove a tapering specimen. The end of conduit is then anastomosetod the coronary artery. I n open technique, which is usually done for LAD, the cnlirc length of the artery is laid open, atheromalous plaque is removed and a saphenous vein patch plasty is done. On to the centre of the vein patch, arterial graft is aliastornosed. Endarterectomy may lead to higher peri operative I MI, graft occlusion, arrhythmis, low cardiac output fluid slightly increaser1 mortality. The consensus among surgeons is to avoid endarterectonly altogether.
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