The problems are overviewed with performing revascularization of the coronary bed when in diffuse affliction. The unique way how to revascularize a progressive atherosclerotic disorder of the coronary bed consists in elimination of a degenerated portion of the coronary vessel which is endarterectomy (EAE). This method is specially important in ischemic myocardium supplied with so disordered coronary. The EAE of the coronaries is of routine use with some extended working sites. However, they are not rare to take this method with some objections. These are due to a higher risk in performing surgery and scepticism upon the long term patency of the endarterectomized artery. Because of a polymorph character of atherosclerotic process, one should hardly mention some randomized studies able to prove both inconvenience and advantages of the method. Nevertheless, the large sets are known to exist at present which document the benefit of the EAE method from the scope of both immediate and long term results. This method is only efficient under the condition of a perfect technical skill as well as peculiar and total EAE completion. Besides the known "gas EAE" and "manual EAE" techniques, the authors present a new EAE approach developed by their own using the solution which is injected under tension into the separation layer. The EAE method appeared to be valuable on multiple cardio-surgical centres when correctly indicated and performed including the instantaneous recognition and correction of imminent complications. The authors' experience is in accord with the above conditions.

Kardiochirurgická klinika fakultní nemocnice Hradec Králové