title: Early results of combined carotid endarterectomy and coronary artery bypass grafting in patients with severe coronary and carotid artery disease.
abstract: The management of patients with carotid artery disease who require coronary artery bypass grafting (CABG) remains controversial. Several published series from the USA (including one with prospective randomization) advocate a combined approach of carotid endarterectomy (CEA) followed immediately by coronary artery bypass surgery. However, experience of combined carotid endarterectomy and coronary bypass grafting has not been previously reported by a centre from the United Kingdom. Between 1986 and 1991 we performed this combined procedure on 18 patients who required myocardial revascularization and had co-existing severe (> 70%) carotid stenosis. Sixteen patients (89%) had angina and 11 patients (61%) had symptomatic carotid artery disease. The perioperative mortality was 5.5% and the ipsilateral perioperative stroke rate was 5.5%. These early results are encouraging and suggest that further evaluation of combined carotid endarterectomy and coronary artery bypass surgery is warranted.
authors.affiliation: Department of Surgery, Leicester Royal Infirmary, UK.
authors.forename: R D
authors.initials: RD
authors.lastname: Sayers
authors.forename: M M
authors.initials: MM
authors.lastname: Thompson
authors.forename: M J
authors.initials: MJ
authors.lastname: Underwood
authors.forename: T
authors.initials: T
authors.lastname: Graham
authors.forename: T
authors.initials: T
authors.lastname: Hartshorne
authors.forename: T J
authors.initials: TJ
authors.lastname: Spyt
authors.forename: R K
authors.initials: RK
authors.lastname: Firmin
authors.forename: P R
authors.initials: PR
authors.lastname: Bell
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged