[Impending carotid and coronary artery obstruction. Operative procedure and monitoring].
A 70 year old woman was admitted to the intensive care unit for unstable angina with haemodynamic repercussions which led to a right hemiparesis because of a left carotid stenosis. The worsening neurological deficit required an immediate endarterectomy. Cardiovascular monitoring, particularly during anaesthetic induction and carotid clamping, included a Swan-Ganz catheter which provided continuous control of myocardial damage. At the same time, continuous dopamine and trinitrine infusions were started to maintain adequate cerebral perfusion. This monitoring guaranteed an excellent adaptability throughout the operation. All along, it would have been possible to decide and to carry out a coronary bypass in case of new myocardial damage. The morbidity and mortality of an association of such lesions and its treatment are discussed.
D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic
Obstruction menaçante carotidienne et coronarienne. Tactique opératoire et monitorage.