J Korean Surg Soc.  2011 Jan;80(1):61-66. 10.4174/jkss.2011.80.1.61.

Comparative Results of Combined Coronary Artery Bypass Grafting and Carotid Endarterectomy versus Staged Operation

• Park YJ
• Kim DI
• Roh YN
• Kim WS
• Lee YT
• Kim GM
• Kim DK
• Kim YW

• KMID: 2096621
• DOI: http://doi.org/10.4174/jkss.2011.80.1.61

Abstract

PURPOSE
Between combined and staged operations of carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) for patients with concurrent coronary and carotid disease, each treatment strategy has its own advantages and disadvantages. We attempted to compare early surgical results between the two operations.
METHODS
We retrospectively reviewed medical records of 71 patients who underwent either combined CEA & CABG (n=37) or staged CABG & CEA (n=34) in a single institute between January 2001 and March 2010. After comparing patients' demographics and preoperative neurologic and cardiac status, we compared early (<1 month) postoperative cardiac or neurologic complications and surgical mortality between the 2 groups.
RESULTS
There was no significant difference in patients' demographics and indications for operation the between 2 groups. There were 2 (5.4%) cases of postoperative stroke in combined groups and 1 (2.9%) in staged group. However, there was no myocardial infarction or death. In staged operation group, during the interval time between the two operations, 5 cases (14.7%) of stroke developed, of which, all patients recovered without any sequelae by anticoagulation.
CONCLUSION
After experiencing low postoperative cardiac or neurologic morbidity or mortality after combined CABG and CEA, we conclude that combined CABG and CEA was a safe and feasible treatment option for patients with neurologic symptoms and in stable cardiac status. In the staged operation group of patients, we observed development of neurologic events during the interval period between CABG and CEA. To attain optimal treatment strategy in asymptomatic patients, further prospective study would be required.

Keyword

Endarterectomy; Carotid artery; Coronary artery bypass

MeSH Terms

Carotid Arteries
Coronary Artery Bypass
Coronary Vessels
Demography
Endarterectomy
Endarterectomy, Carotid
Humans
Medical Records
Myocardial Infarction
Neurologic Manifestations
Retrospective Studies
Stroke

Reference

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