Comparison of early outcomes with three approaches for combined coronary revascularization and carotid endarterectomy
Rev. bras. cir. cardiovasc
; 31(5): 365-370, Sept.-Oct. 2016. tab
Article
in En
| LILACS
| ID: biblio-829750
Responsible library:
BR1.1
ABSTRACT
Abstract Objective:
This study aims to compare three different surgical approaches for combined coronary and carotid artery stenosis as a single stage procedure and to assess effect of operative strategy on mortality and neurological complications.Methods:
This retrospective study involves 136 patients who had synchronous coronary artery revascularization and carotid endarterectomy in our institution, between January 2002 and December 2012. Patients were divided into 3 groups according to the surgical technique used. Group I included 70 patients who had carotid endarterectomy, followed by coronary revascularization with on-pump technique, group II included 29 patients who had carotid endarterectomy, followed by coronary revascularization with off-pump technique, group III included 37 patients who had coronary revascularization with on-pump technique followed by carotid endarterectomy under aortic cross-clamp and systemic hypothermia (22-27ºC). Postoperative outcomes were evaluated.Results:
Overall early mortality and stroke rate was 5.1% for both. There were 3 (4.3%) deaths in group I, 2 (6.9%) deaths in group II and 2 (5.4%) deaths in group III. Stroke was observed in 5 (7.1%) patients in group I and 2 (6.9%) in group II. Stroke was not observed in group III. No statistically significant difference was observed for mortality and stroke rates among the groups.Conclusion:
We identified no significant difference in mortality or neurologic complications among three approaches for synchronous surgery for coronary and carotid disease. Therefore it is impossible to conclude that a single principle might be adapted into standard practice. Patient specific risk factors and clinical conditions might be important in determining the surgical tecnnique.Key words
Full text:
1
Index:
LILACS
Main subject:
Coronary Artery Disease
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Coronary Artery Bypass
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Endarterectomy, Carotid
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Carotid Stenosis
/
Stroke
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Rev. bras. cir. cardiovasc
Journal subject:
CARDIOLOGIA
/
CIRURGIA GERAL
Year:
2016
Type:
Article