The impact of coronary artery disease on carotid endarterectomy.
In a series of 531 CENDX, preoperative cardiac risk was categorized by clinical criteria. Patients with CAD (history of previous MI, angina, congestive heart failure, and/or electrocardiographic evidence of CAD were selected for more invasive studies based on clinical criteria. The overall incidence of postoperative myocardial infarction was 2.5% and increased slightly to 4% in patients with symptomatic cardiac disease. More importantly, the overall mortality was 0.9% and only 3 of 13 (23%) postoperative myocardial infarctions were fatal. Neurologic complications averaged 1.4% and approximately 70% were related to preceding cardiac events. Twenty-two patients or 4% of the entire series underwent carotid endarterectomy combined with coronary artery bypass graft and this approach was associated with one death and one stroke. Therefore, we conclude that a selective approach to coronary arteriography and subsequent CABG based on clinical criteria is associated with an acceptably low mortality and cardiac morbidity.
D001161:Arteriosclerosis / Q000401:mortality / Q000601:surgery; D002339:Carotid Arteries / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000209:etiology; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D004691:Endarterectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D012306:Risk