Summary
Simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CE) were performed on 133 patients over an eight-year period. Twenty-seven patients (20%) had previous TIAs, 12 (9%) had previous strokes, the remainder were asymptomatic (71%). All asymptomatic patients had greater than 85% stenosis of the internal carotid artery demonstrated by noninvasive ultrasound and four-vessel angiography. CE was performed prior to the sternotomy for coronary artery bypass under the same anesthesia. Nineteen patients had bilateral carotid artery disease. Postoperatively three patients suffered strokes (2.2%), an additional three patients (2.2%) suffered transient upper extremity weakness; one patient from each of these groups died. There were no post-op strokes or TIAs in patients with bilateral carotid artery disease. Average length cf hospital stay was 10 days. Our experiences lead us to conclude that the morbidity/mortality of the simultaneous procedure is not affected by bilateral carotid artery disease. We believe that in patients with symptomatic coronary artery disease and symptomatic carotid artery disease, or asymptomatic carotid artery disease with a high grade stenosis, simultaneous repair of both lesions should be undertaken.
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References
Perler BA, Burdick JF, Williams GM. The Safety of CEA at the Time of CABG: Analysis of Results in a High Risk Patient Population. J Vasc Surg 1985;2:558–563.
Berkoff HA, Turnipseed WD. Patient Selection and Results of Simultaneous Coronary, Carotid Artery Procedures. Ann Thorac Surg 1984;38:172–175.
Ennix CL, Lawrie GM, Morris GC, et al. Improved Results of Carotid Endar-terectomy in Patients with Symptomatic Carotid Artery Disease: An Analysis of 1546 Consecutive Carotid Operations. Stroke 1979;10:122–125.
O’Donnell TF, Jr, Collow AD, Willet C, et al. The Impact of Coronary Artery Disease on CEA. Ann Surg 1983;198;705.
Bernhard VM, Johnson WD, Peterson JJ. Carotid Artery Stenosis Association with Surgery for Coronary Artery Disease. Arch Surg 1972;105:837–840.
Urschel HC, Razzuk MA, Gardner MA. Management of Concomitant Occlusive Disease of the Carotid and Coronary Arteries. J Thorac Cardiovasc Surg 1976;72:829.
Okies JE, MacManus Q, Starr A. Myocardial Revascularisation and Carotid Endarterectomy. A Combined Approach. Ann Thorac Surg 1977;23:560.
Check WA. Simultaneous Coronary Bypass and Carotid Endarterectomy Advocated. JAMA 1978;250:725.
Morris GC, Ennix CL, Lawrie GM, et al. Management of Coexistent Carotid and Coronary Artery Occlusive Atherosclerosis. Clev Clin Q 1978;45:125.
Craver JM, Murphy DA, Jones E, et al. Con? Carotid and Coronary Artery Revascularization. Ann Surg 1982;195:712–720.
Hertzer NR, Loop FD, Taylor PC, Beren EG. Staged and Combined Surgical Approach to Simultaneous Carotid and Coronary Vascular Disease. Surg 1978;84:803–811.
Carey JS, Cuningnan RA. Complications of Combined Brachiocephalic and Coronary Revascularization. Ann Thorac Surg 1978;25:385.
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© 1992 Springer-Verlag New York Inc.
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Halpin, D.P. et al. (1992). Combined Carotid and Coronary Artery Surgery. In: Chang, J.B. (eds) Modern Vascular Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2946-9_8
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DOI: https://doi.org/10.1007/978-1-4612-2946-9_8
Publisher Name: Springer, New York, NY
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