CAROTIS AND CORONARY ARTERY DISEASE: IS CONCOMITANT OPERATION NECESSARY?

Serdar Çimen, Vedat Özkul, Batuhan Özay, Bülend Ketenci, Mehmet Güney, Rafet Günay, Erin Tüysüz, Serdar Dağ, Murat Demirtaş

Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İstanbul

Background: As it is assumed that coexisting carotid lesions increase neurological complications following coronary revascularization operations, concomitant operation is advocated. On the contrary simultaneous operations are more complicated and may not always decrease postoperative mortality and morbidity thereby leading ongoing controversy. On the other hand increasing trend of performing carotid endarterectomy under local anesthesia and the wide-spread application of beating heart coronary surgery, have all renovated new strategies in coexistent disease situations.

Methods: In our center between 2002-2003 years 15 coronary cases with carotid lesions have undergone coronary revascularization with beating heart technique without intervening carotid lesion due to various reasons.

Results: Only one patient has been lost due to mediastinitis and in one case transient monoparesy has been accounted. Beating heart technique by eliminating detrimental systemic and especially hematological and cerebral side effects of cardiopulmonary bypass, has been a preferred revascularization technique in recent years.

Conclusions: On the other hand reversed staged operation enables carotid endarterectomy performed under local anesthesia in future. Although number of cases im this cohort is small to come to a definite conclusion, our early results encourages this kind of reversed staged operation to be performed.

Keywords : Carotis, coronary anderterectomy revascularization, reversed staged operation, cancomitant operation, beating heart

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