[Simultaneous coronary and vascular surgery interventions: indications,technique and results]

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Atherosclerosis Research

Context:

• Atherosclerosis frequently affects multiple vascular systems, including coronary, carotid, and aortoiliac arteries.
• Patients with coronary atherosclerosis often present with coexisting carotid disease, abdominal aortic aneurysms, or aortoiliac occlusive disease.
• Treatment decisions involve staged procedures or synchronous surgery, combining coronary artery bypass grafting (CABG) with other vascular interventions.

Purpose:

• To evaluate the safety and efficacy of synchronous surgical procedures combining CABG with other vascular operations.
• To compare the outcomes of synchronous surgery versus staged approaches for patients with multi-site atherosclerotic disease.

Summary:

• A total of 123 synchronous CABG and vascular procedures were performed between 1978 and July 1990.
• These combined procedures constituted 3.5% of all CABG surgeries during the study period.
• Specific combinations included CABG with carotid endarterectomy (45 cases), abdominal aortic aneurysm resection (31 cases), and aortoiliac/femoral procedures (28 cases).

Impact:

• Synchronous surgery offers advantages by reducing the number of operations, eliminating risks associated with delayed treatment, and accelerating overall surgical management.
• This approach is beneficial for patients with generalized atherosclerosis requiring intervention in multiple vascular territories.
• Carotid endarterectomy is prioritized before CABG in specific symptomatic carotid disease scenarios.