Original Article

Simultaneous carotid endarterectomy and myocardial revascularization by using cardiopulmonary bypass for both procedures

10.5455/gulhane.15394

  • Ahmet Kırbaş
  • Nurşen Tanrıkulu
  • Ayşegül Sünbül
  • Ömer Işık

Received Date: 05.02.2012 Accepted Date: 08.04.2012 Gulhane Med J 2012;54(4):284-288

This study retrospectively reviewed early outcomes after the carotid endarterectomy combined with coronary artery bypass grafting (CABG). Between January 2007 and March 2011, 52 patients who underwent combined myocardial revascularization and carotid endarterectomy in a single-stage procedure. The principal indication was the need for symptomatic or asymptomatic carotid stenosis of 80% stenosis or more. The mean age was 66.4 ±6.6 years (range 50-75). 34 patients (65.4%) were male, 18 patients (34.6%) female. Mean number of the grafts 2.7, mean ejection fraction was (EF) % 49.6 ±8.4. A total of 22 patients (42.3%) had a previous myocardial infarction, 7 patients (13.4%) presented with unstable angina and one patient (1.9%) had prior coronary artery bypass grafts. The average cardiopulmonary bypass time was 83.2±41.7 (range 30-204) min and crossclamping time was 31.8±11.8 (range 18-67) min. Early overall mortality was 3 (5.7%), of which 2 were cardiac related (3.8%). Other cause of death was fatal stroke in one patient (1.9%). Perioperative morbidity included myocardial infarction in 1 patient (1.9%) , neurologic deficit in 3 (5.7%), 2 patients (3.8%) low cardiac output syndrome. Carotid endarterectomy and myocardial revascularization in conjunction with cardiopulmonary bypass is a method safe enough to prefer its routine use with acceptable low operative risk.

Keywords: Carotid endarterectomy, coronary artery bypass grafting, postoperative complications, etiology