ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
COMBINED SURGERY FOR CORONARY AND CAROTID ARTERY DISEASE: MANAGEMENT AND RESULTS
Fikri Yapıcı, Onur Gürer, Yavuz Enç, Bayer Çınar, Mehmet R Güney, Nihan Yapıcı, Fuat Bilgen, Azmi Özler
Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul
Background: Myocardial infarction has been described as a frequent complication of carotid endarterectomy. Likewise, stroke has been seen as a major complication following myocardial revascularization. In this study, we aimed to evaluate mortality – morbidity, and early – and midterm results of the patients who underwent combined surgery for coronary and carotid artery disease.

Methods: A consecutive series of 30 patients with coexisting severe coronary and carotid artery disease were operated during the five year period. Standart combined surgical procedures were coronary bypass grafting and carotid endarterectomy in all of 30 patients. In the early and midterm follow up, risk factors, mortality and eventless survival rates were evaluated with this group of patients.

Results: There were one stroke (3.3%) and three reversible neurological deficits (9.9%) in the early perioperative period. There was no early mortality. Carotid and aortic mean clamping times were 22 ± 6.8 min and 50 ± 14 min, respectively. Patients were discharged after a mean length of stay in intensive care unit (Icu) of 51 ± 4.5 hour and 7.4 ± 1.2 days of post-ICU hospitalization. Six hundred twelve patient-month follow up was realized in 87% of patients. Overall late mortality was 10% with three patients. There was one major stroke (3.3%) in the follow-up period.

Conclusion: Combined interventions of carotid endarterectomy and aortocoronary bypass grafting can be performed with an acceptable morbidity and mortality when severe carotid stenosis is associated with advanced, symptomatic coronary artery disease.

Keywords : Carotid endarterectomy, coronary bypass, combined surgery
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