Instituto do Coração do Hospital das Clínicas- FMUSP

Objective- To determine the risk factors for mortality related to myocardial revascularization when performed in association with coronary endarterectomy. Methods- We assessed retrospectively 353 patients who underwent 373 coronary endarterectomies between January ’89 and November ’98, representing 3.73 % of the myocardial revascularizations in this period of time. The ar-teries involved were as follows: right coronary artery in 218 patients (58.45%); left anterior descending in 102 patients (27.35%); circumflex artery in 39 patients (10.46%); and diagonal artery in 14 patients (3.74%). We used 320 (85.-79%) venous grafts and 53 (14.21%) arterial grafts. Results- In-hospital mortality among our patients was 9.3 % as compared with 5.7 % in patients with myo-cardial revascularizations without endarterectomy (p=0.003). Cause of death was related to acute myocar-dial infarction in 18 (54.55%) patients. The most signifi-cant risk factors for mortality identified were as follows: diabetes mellitus (p=0.001; odds ratio =7.168), left main disease (<0.001; 9.283), female sex (0.01; 3.111), acute myocardial infarction (0.02; 3.546), ejection fraction <35 % (<0.001; 5.89), and previous myocardial revascu-larization (<0.001; 4.295). Conclusion – Coronary endarterectomy is related to higher mortality, and the risk factors involved are impor-tant elements of a poor outcome. Key words- coronary endarterectomy, myocardial revas-cularization, atherosclerosi