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[Results of simultaneous myocardial and cerebral revascularization surgery]
P Nataf1, I Gandjbakhch, M Fontanel
1Service de chirurgie thoracique et cardio-vasculaire, hôpital de la Pitié, Paris.
Insights
Simultaneous heart and brain revascularization surgery in patients with multiple arterial disease shows a low operative mortality and no neurological complications. This suggests combined surgical treatment is a safe option for severe carotid and coronary lesions.
Area of Science:
- Cardiovascular Surgery
- Neurological Surgery
Context:
- Aorto-coronary bypass surgery is a common procedure for coronary artery disease.
- Simultaneous cerebral revascularization addresses carotid artery disease.
- Patients with multiple arterial disease present complex surgical challenges.
Purpose:
- To evaluate the safety and efficacy of combined myocardial and cerebral revascularization.
- To assess operative mortality, peri-operative complications, and long-term survival rates.
Summary:
- A study of 48 patients undergoing simultaneous aorto-coronary bypass and cerebral revascularization between 1979 and 1987.
- Reported an operative mortality rate of 4.2% and peri-operative myocardial infarction in 6.2% of cases.
- Observed no neurological complications and a 5-year survival rate of 74.8%.
Impact:
- The findings support the systematic combined surgical treatment for patients with severe carotid and coronary artery disease.
- Highlights the safety of combined procedures, particularly the absence of neurological complications.
- Contributes to the understanding of outcomes for complex multi-arterial disease management.
Abstract:
Out of 3,678 patients who underwent aorto-coronary bypass between May, 1979 and October, 1987 at the La Pitié Hospital, Paris, 48 had simultaneous myocardial and cerebral revascularization. Operative mortality rate was 4.2 p. 100. Peri-operative myocardial infarction occurred in 3 cases (6.2 p. 100). No neurological complication was observed. The survival rate at 5 years (operative mortality included) was 74.8 +/- 8.66 p. 100. These results obtained in patients with multiple arterial disease are in agreement with those found in the literature. The lack of neurological complications is in favour of a systematic combined surgical treatment of severe carotid and coronary lesions.