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Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
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Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia

Published on: May 9, 2013

Combined surgical approach to carotid and coronary artery disease

Cristijan Bulat1, Igor Alfirević, Zvonimir Ante Korda

  • 1Department of Cardiovascular Surgery, Special Hospital for Cardiovascular Surgery and Cardiology Magdalena, Krapinske Toplice, Croatia. cristijan.bulat@zg.htnet.hr

Collegium Antropologicum
|May 23, 2008
PubMed

Insights

Combined carotid endarterectomy and coronary artery bypass grafting (CEA/CABG) is safe and effective. Both cardiopulmonary bypass (CPB) and off-pump techniques showed no significant differences in neurological events or mortality.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Vascular Surgery

Background:

  • Coexistent carotid and coronary artery disease presents a complex surgical challenge.
  • Combined procedures aim to address both conditions simultaneously, but optimal technique remains debated.

Purpose of the Study:

  • To compare the safety and efficacy of combined carotid endarterectomy and coronary artery bypass grafting (CEA/CABG) using cardiopulmonary bypass (CPB) versus off-pump techniques.

Main Methods:

  • Thirty-five patients with severe carotid and coronary artery disease underwent combined CEA/CABG.
  • Patients were divided into two groups: one with CPB (arrested heart) and one off-pump (beating heart).
  • Outcomes including perioperative neurological events, mortality, and myocardial infarction were assessed.

Main Results:

  • No transient or permanent perioperative neurological events occurred in either group.
  • Early mortality was 5.6% and perioperative myocardial infarction was 5.5% across both groups.
  • No late strokes were observed during the follow-up period.

Conclusions:

  • Combined CEA/CABG is a safe and effective procedure for patients with severe, coexistent carotid and coronary artery disease.
  • Both CPB and off-pump techniques demonstrate comparable safety profiles regarding neurological and cardiac outcomes.
  • The choice between CPB and off-pump may not significantly impact early or late outcomes in this combined procedure.

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