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Related Experiment Videos

Combined carotid and coronary surgery.

S Lubicz1, A Kelly, P L Field

  • 1Open Heart Surgery Unit, University of Melbourne Teaching Hospitals, St Vincent's Hospital, Victoria, Australia.

The Australian and New Zealand Journal of Surgery
|September 1, 1987
PubMed
Summary

Combined carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) in high-risk patients showed a low permanent stroke rate of 2.6%. This combined procedure is a viable option for patients with severe coronary and carotid disease.

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Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Vascular Surgery

Background:

  • Patients with severe coronary artery disease (CAD) and extracranial carotid stenosis often require both coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA).
  • The combined procedure aims to mitigate risks of myocardial infarction and cerebral ischemia in high-risk individuals.

Purpose of the Study:

  • To determine the stroke rate associated with combined CEA/CABG procedures.
  • To evaluate the safety and efficacy of performing CEA and CABG concurrently.

Main Methods:

  • A retrospective review of 40 consecutive patients undergoing combined CEA/CABG was conducted.
  • Patients had severe CAD and either signs of cerebral ischemia or asymptomatic carotid bruits.
  • CEA was performed prior to CABG under a single general anesthetic.

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Main Results:

  • Six patients (15.4%) experienced postoperative cerebral ischemic events.
  • These included reversible ischemic neurological deficit (7.7%), transient ischemic cerebral event (5.1%), and permanent stroke (2.6%).
  • Two cardiac-related deaths occurred (5% mortality).

Conclusions:

  • Combined CEA/CABG can be performed with a permanent stroke rate comparable to individual procedures.
  • The procedure is a safe option for patients with combined coronary and carotid vascular disease at risk of infarction.
  • Mortality for the combined procedure was 5%.