[Single-staged operation for the patients with concomitant diseases of coronary and carotid arteries]

Area of Science:

• Cardiovascular Surgery
• Neurological Surgery
• Vascular Surgery

Context:

• Concomitant severe stenosis in coronary and carotid arteries presents a complex surgical challenge.
• Patients requiring coronary artery bypass grafting (CABG) may also have significant extracranial carotid stenosis.
• Symptomatic carotid stenosis necessitates cerebral revascularization to prevent stroke.

Purpose:

• To evaluate the safety and efficacy of combined coronary artery bypass grafting (CABG) and cerebral revascularization procedures.
• To assess the feasibility of performing carotid endarterectomy (CEA) or carotid artery bypass grafting concurrently with CABG.
• To determine the potential for avoiding perioperative myocardial infarction and neurological complications.

Summary:

• Four cases of concomitant severe coronary and carotid stenosis treated with combined procedures are described.
• Cerebral revascularization included carotid endarterectomy (CEA) in three patients and carotid artery bypass grafting in one.
• One patient underwent percutaneous transluminal stenting of the internal carotid artery before combined left CEA and CABG.
• No perioperative myocardial infarction or neurological complications were observed in any of the cases.

Impact:

• Combined procedures for severe coronary and carotid stenosis are safe and effective.
• This combined approach can successfully prevent major perioperative complications like myocardial infarction and stroke.
• The study highlights the desirability of combined cerebral revascularization and CABG in select patient populations.