Right coronary endarterectomy: a procedure with increased risk of perioperative infarction.

Although right coronary endarterectomy extends operability on this vessel, the procedure is associated with increased risk of perioperative infarction. Forty-nine patients at St Vincent's Hospital underwent endarterectomy and saphenous vein grafting to the distal right coronary artery, with a hospital mortality of 6.1% and a perioperative infarction rate of 20.4%, compared with rates of 4.2% and 10.9% respectively in a group of patients who did not require endarterectomy. These figures show a trend toward statistical significance which suggests that careful patient selection for endarterectomy is required to obviate an increased risk of complications with this procedure.