Coronary endarterectomy: the long-term local effects

The chronic effects of manual endarterectomy of coronary arteries are described. Nine male patients (age, 58-70 years) had undergone right coronary endarterectomy and bypass grafting 6-9 years prior to death and autopsy. One of the nine endarterectomized arteries had thrombosed soon after the procedure, while the other eight had maintained blood flow for up to eight years. These patent arteries had variable myofibrointimal proliferation ranging from mild to marked, the latter with significant stenosis. Recurrent atherosclerosis was present focally in two endarterectomized arteries. Death had occurred from causes unrelated to pathology in the endarterectomized vessels and provided a unique opportunity to assess the variable long-term effects of this form of arterial injury.