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[Simultaneous operations of the carotid bifurcation and coronary vessels in moderate systemic hypothermia]
J Cremer1, W Harringer, M Brandt
1Abteilung für Herz- und Gefässchirurgie, Christian-Albrechts-Universität Kiel.
Insights
Simultaneous carotid endarterectomy and coronary revascularization in patients with both coronary heart disease and carotid stenosis is a viable surgical option. This combined approach, using moderate hypothermic extracorporeal circulation, demonstrated low 30-day mortality and stroke rates.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Context:
- Comorbidity of coronary heart disease (CHD) and carotid artery stenosis presents a complex challenge for surgical management.
- Determining the optimal surgical strategy for patients with concurrent CHD and carotid stenosis is critical.
Purpose:
- To evaluate the safety and efficacy of a simultaneous surgical approach for patients with concomitant coronary heart disease and carotid stenosis.
- To assess perioperative outcomes, including mortality, stroke, and myocardial infarction, following combined carotid endarterectomy and coronary revascularization.
Summary:
- A simultaneous surgical strategy involving carotid endarterectomy and coronary revascularization was performed in 48 patients.
- Both procedures were conducted under moderate hypothermic extracorporeal circulation.
- The study reported a 30-day mortality rate of 2.1% and a perioperative incidence of permanent stroke of 2.1%, with 0% incidence of myocardial infarction.
Impact:
- The findings suggest that a simultaneous surgical approach is a safe and effective option for managing patients with combined coronary heart disease and carotid stenosis.
- This approach may help stratify surgical risk and improve outcomes in this complex patient population.
- The study provides valuable data for clinical decision-making in the surgical treatment of patients with dual cardiovascular and cerebrovascular disease.
Abstract:
Comorbidity of coronary heart disease and carotid stenosis raises the question of surgical stratification. A simultaneous approach of carotid endarterectomy and coronary revascularization, both under conditions of moderate hypothermic extracorporeal circulation, was applied in 48 patients. Considering the complexity of the procedures required the 30-day mortality (2.1%) and perioperative incidence of permanent stroke (2.1%) or myocardial infarction (0%) appeared to be comparably low.