Simultaneous carotid endarterectomy and myocardial revascularization by using cardiopulmonary bypass for both...

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Cerebrovascular Surgery

Background:

• Optimal treatment for patients with co-existing coronary and carotid arterial disease remains controversial.
• Simultaneous surgical intervention is an option, but its safety and efficacy require further investigation.

Purpose of the Study:

• To evaluate the safety and outcomes of performing simultaneous carotid endarterectomy and coronary artery bypass grafting.
• To assess the combined procedure's morbidity and mortality rates.

Main Methods:

• Seventy-two patients with both coronary and carotid arterial disease underwent simultaneous carotid endarterectomy and coronary artery bypass grafting.
• The combined procedure was performed during cardiopulmonary bypass with mild hypothermia and pulsatile perfusion for cerebral protection.
• Indications for carotid endarterectomy included >75% lumen diameter reduction or unstable plaque.

Main Results:

• The mean cardiopulmonary bypass time was 64.7 minutes and aortic cross-clamp time was 32.4 minutes.
• Perioperative neurological complications occurred in 5.5% of patients, with permanent deficits in 2.7%.
• The procedure-related mortality rate was 4.1%.

Conclusions:

• Simultaneous carotid endarterectomy and coronary artery bypass grafting under cardiopulmonary bypass is a safe and feasible surgical option.
• The combined procedure demonstrates acceptable morbidity and mortality rates for selected patients.
• This approach offers a viable solution for managing complex cardiovascular and cerebrovascular disease concurrently.