Surgical experiences in concomitant carotid endarterectomy and coronary artery bypass surgery

Abstract

Introduction: We aimed to investigate the results of concomitant carotid endarterectomy and coronary artery bypass grafting operations in patients with coronary artery disease and carotid artery stenosis. Patients and Methods: 38 consecutive patients who were operated on concomitantly were included in this study. Digital substraction angiography or computerized tomoghraphic angiography was performed for the patients and stenosis 70 % or higher were accepted for operation. The mean age was 69 ± 8,5. There was a history of vertigo in 21 (55.3 %), syncope in 10 (26.3 %), carotid souffle in 16 (42.1 %), and transient ischemic attack in 12 (31.6 %) patients. 17 (44,7 %) patients were asymptomatic. Carotid endarterectomy was performed first and patch angioplasty was performed with synthetic patch. Then, intraluminal shunt was used for all patients. Coronary artery bypass grafting was performed under cardiopulmonary bypass. Proximal anastomosis were fashioned under single cross clamp. Results: Hospital deaths occured in one patient due to low cardiac output. The mean length of intensive care unit stay was 16.9 ± 7.4 hours, ventilatıon period 7 ± 1,5 hours and mean length of hospital stay was 6.6 ± 2.9 days. Conclusion: Concomitant carotid endarterectomy and coronary artery bypass grafting operations can be safely performed with using intraluminal shunt in patients with significant carotid artery stenosis and coronary artery disease.