Prevalence of Carotid Stenosis in Heart Valve Surgery and the Role of Routine Screening
Osman Fehmi Beyazal1, Nihan Kayalar1, Mehmed Yanartaş1
1Department of Cardiovascular Surgery, İstanbul Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye.
Background:
The aim of this study is to determine the prevalence of carotid stenosis (CS) in isolated coronary artery bypass grafting (CABG) and isolated heart valve surgery in the center, identify associated risk factors, and discuss the necessity of routine screening.
Methods:
Between 2020 and 2023, a total of 834 patients who had undergone isolated CABG and heart valve surgery were included in the study. The patients were divided into 2 groups: group A (n = 640, isolated CABG) and group B (n = 194, isolated valvular surgery). Subgroups were then created based on age. Group 1 (n = 431, ≥ 60 years), group 2 (n = 371, 40-60 years) and group 3 (n = 32, <40 years). Prevalence of CS, preoperative and postoperative outcomes were compared between groups.
Results:
The prevalence of CS ≥ mild, ≥ moderate, and ≥ severe was all higher in group A than in group B. There was no significant difference in cerebrovascular accident (CVA) between groups A and B 9 (1.4%) vs. 1 (0.5%). A positive significant association was found between advanced age (≥ 60 years), CABG, and CS (OR = 2.105 and OR = 1.899) respectively. Carotid stenosis was not found in any patients under the age of 40. In isolated heart valve surgery patients aged 60 and over, the prevalence of mild or higher CS was 15 (16.9%), moderate or higher CS was 13 (14.6%), and severe or higher CS was 2 (2.2%). In isolated valvular surgery patients aged 40-60, the prevalence of mild or above CS was 5 (6.3%), moderate or above CS was 3 (3.8%), and severe or above CS was 2 (2.5%).
Conclusion:
A significant prevalence of CS in patients over the age of 60 undergoing isolated heart valve surgery was found. Screening for CS should be conducted in this patient population, especially in individuals over 60. Screening could also be beneficial for patients over 40, while routine screening is likely unnecessary for those under 40 without cardiovascular risk factors. Cite this article as: Beyazal OF, Kayalar N, Yanartaş M. Prevalence of carotid stenosis in heart valve surgery and the role of routine screening. Eurasian J Med. 2026, 58(3), 1286, doi: 10.5152/eurasianjmed.2026.251286.
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