CONCOMITANT SURGERY FOR CORONARY REVASCULARIZATION AND CAROTID ENDARTERECTOMY: MANAGEMENT AND RESULTS

Purpose: Atherosclerosis is a systemic pathology and patients who will undergo coronary artery bypass operations may have carotid disease as well. There is still controversy about the management of these patients. The results of the simultaneous carotid endarterectomy and coronary artery bypass grafting (CABG) operations performed in our clinic are discussed.

Materials and Methods: Between 2002 and 2004 16 patients underwent simultaneous carotid endarterectomy and CABG operations. In 14 patients, under carotid endarterectomy operations preceded CABG under general anesthesia. In 2 patients with bilateral carotid stenosis, endarterectomies were performed under full heparinization, hipothermia and cardiopulmonary bypass support. Carotid shunts were used in 4 patients.

Results: The mean coronary artery by pass number was 3.2. The mean cross clamping and cardiopulmonary times were 52±11 and 86±18 minutes respectively. Perioperatively there was no myocardial infarction (MI). 2 patients had stroke and 1 patient had neurological deficit. One patient died due to neurological complication in the early postoperative period and 1 patient died due to mediastinitis in late postoperative period.

Conclusion: Carotid stenosis is a major risk factor that increases morbidity and mortality in patients who will undergo CABG operations. Concomitant carotid endarterectomy and CABG are feasible with acceptable morbidity and mortality rate. (Turkish J Vasc Surg 2005;14(3):33-38).