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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
Simultaneous coronary artery bypass grafting and carotid endarterectomy can be performed with low mortality rates
Ebuzer Aydin1, Yucel Ozen2, Sabit Sarikaya2
1Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey. ebuzermd@gmail.com.
Insights
Simultaneous carotid endarterectomy (CEA) and coronary artery bypass graft (CABG) surgery is a viable option for patients with both conditions, demonstrating low mortality and morbidity rates.
Area of Science:
- Cardiovascular Surgery
- Neurological Surgery
Background:
- Concomitant carotid and coronary artery disease presents a complex treatment challenge.
- Optimal management strategies remain a subject of debate in clinical practice.
Purpose of the Study:
- To evaluate the safety and efficacy of simultaneous carotid endarterectomy (CEA) and coronary artery bypass graft (CABG) surgery.
- To report clinical experience and outcomes in patients undergoing combined procedures.
Main Methods:
- Retrospective analysis of 110 patients (1996-2009) who underwent simultaneous CEA and CABG.
- Inclusion of demographic data and cardiovascular risk factors (hypertension, diabetes, hyperlipidemia, smoking, peripheral arterial disease).
Main Results:
- Low mortality rate of 0.9% (one death due to ventricular fibrillation).
- Peri-operative neurological complication rate of 6%, with 3% major stroke and 2% transient hemiparesis.
- Absence of peri-operative myocardial infarction.
Conclusions:
- Simultaneous CEA and CABG can be performed with acceptable safety.
- The combined procedure offers a low rate of mortality and morbidity for selected patients.
Introduction:
There is controversy over the best approach for patients with concomitant carotid and coronary artery disease. In this study, we report on our experience with simultaneous carotid endarterectomy (CEA) and coronary artery bypass graft (CABG) surgery in our clinic in the light of data in the literature.
Methods:
Between January 1996 and January 2009, a total of 110 patients (86 males, 24 females; mean age 65.11 ± 7.81 years; range 44-85 years), who were admitted to the cardiovascular surgery clinic at our hospital, were retrospectively analysed. All patients underwent simultaneous CEA and CABG. Demographic characteristics of the patients and a history of previous myocardial infarction (MI), hypertension, diabetes mellitus, hyperlipidaemia, peripheral arterial disease and smoking were recorded.
Results:
One patient (0.9%) with major stroke died due to ventricular fibrillation. Peri-operative neurological complications were observed in seven patients (6%). Complications were persistent in two patients. Four patients (3%) had postoperative major stroke, whereas three patients (2%) had transient hemiparesis. No peri-operative myocardial infarction was observed.
Conclusion:
Simultaneous CEA and CABG can be performed with low rates of mortality and morbidity.
