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\begin{document}

\title{Full endarterectomy of Right coronary artery (RCA) and all branches}



\author[1]{mahdi daliri}%
\author[1]{Farshad Shakerian}%
\author[1]{Sanaz Asadian}%
\author[1]{Yaser Toloueitabar}%
\author[1]{Alireza Yaghoubi}%
\affil[1]{Rajaie Cardiovascular Medical and Research Center}%


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  \date{June 13, 2024}


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\begin{abstract}
This case is a unique 49 years old male with clear images of diagnosis
angiography, operation field and post operation findings to show total
right coronary artery plaque and how full endarterectomy can help
patient.%
\end{abstract}%



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\textbf{Full endarterectomy of Right coronary artery (RCA) and all
branches}

Total endarterectomy of RCA

Mahdi Daliri \textsuperscript{1}, MD, Farshad
Shakerian\textsuperscript{1}, MD, Sanaz Asadian\textsuperscript{1},MD,
Yaser Toloueitabar\textsuperscript{1}, MD, Alireza Yaghoubi
Golverdi\textsuperscript{1} ,MD

1. Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran

Corresponding Author: Mahdi Daliri, Division of cardiac surgery, Hashemi
Rafsanjani HW, Rajaei hospital, Tehran, IRAN. Post code: 1995614331,
mobile No.: +989151040818, email: m\_daliri@yahoo.com

words count: 361

Keywords: Right coronary artery, endarterectomy, CABG, CT Angio

Coronary endarterectomy (CEA) was proposed as a treatment strategy for
coronary diseases in the mid-20\textsuperscript{th} century; however, as
a result of being complicated and unpredictable, it was not welcomed by
the physicians. The majority of surgeons do not use the procedure for
cases with diffuse or complete right coronary artery lesions. (1)

CEA is a sophisticated technique which should be applied only by
experienced surgeons, and in patients with diffuse coronary artery
diseases, in whom other options have not been effective. (2)

A 49-year-old male was admitted to the department with chest pain and
high creatinine. The patient underwent angiography; the results showed
total occlusion of RCA and significant stenosis of LAD and LCX. (Fig 1A)
Upon one session of dialysis, CABG was conducted for the patients.
Moreover, due to the diffuse calcification of the RCA and PDA, the total
CEA of RCA and its branches was conducted by a 5-mm incision on PDA.
(Fig 1B) One month later, the general condition of the patient was good,
and the CT-Angio showed the opening of RCA and its branches. . (Fig 1C)

Key clinical message

Full endarterectomy of right coronary artery (RCA) is an effective
treatment of total occlusion of RCA but the technique for full
extraction of plaque is more important.

Conflict of interest

The authors declare no conflict of interest.

Author contributions

DD and FS: contributed to acquisition of data, drafting the manuscript,
final revision of the manuscript, and participated sufficiently in the
work. SA, YT and AYG: contributed to acquisition of data, drafting the
manuscript, and participated sufficiently in the work.

Ethical approval

The report was performed in accordance with the ethical standards as
laid down in the 1964 Declaration of Helsinki and its later amendments
or comparable ethical standards. Also, it is in accordance with
institutional policies in this subject.~Informed Consent: Written
informed consent has been obtained from the patient.

Funding information

No funding sources

Acknowledgements

Nothing to be mentioned

Availability of data and material

The datasets generated during the current report are available from the
corresponding author on reasonable request.

References:

Erdil N, Cetin L, Kucuker S, Demirkilic U, Sener E, Tatar H. Closed
endarterectomy for diffuse right coronary artery disease: early results
with angiographic controls.~\emph{J Card Surg} . 2002; 17(4):261-266.

Papakonstantinou NA, Baikoussis NG, Apostolakis E. Coronary
endarterectomy: new flavors from old recipes.~\emph{J Cardiol} . 2014;
63(6):397-401.

Figure legend: Fig 1: Full endarterectomy of right coronary artery
(RCA). 1A: Total occlusion of RCA in angiography. 1B: Image of long and
total plaque of RCA and it's all branches. 1C: CT angiography view of
patent RCA and other grafts after one month after surgery\selectlanguage{english}
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