title: A surgical approach to coexistent coronary and carotid artery disease.
abstract: OBJECTIVE
  To assess the early results of combined coronary artery bypass graft surgery and carotid endarterectomy.
  
  
  METHODS
  Retrospective and ongoing analysis of patients who underwent combined coronary artery bypass graft surgery and carotid endarterectomy.
  
  
  METHODS
  Cardiothoracic unit in a London teaching hospital.
  
  
  METHODS
  From June 1987 to March 1995, 64 patients were identified. They were patients who were scheduled to have coronary artery bypass graft surgery or required urgent coronary revascularisation and who were found to have significant coexistent carotid disease. (Unilateral carotid stenosis > 70%, bilateral carotid stenosis > 50%, or unilateral carotid stenosis > 50% with contralateral occlusion.)
  
  
  METHODS
  Both procedures were performed during one anaesthesia: the carotid endarterectomy was performed first without cardiopulmonary bypass. After completion of carotid endarterectomy, coronary artery bypass graft surgery was performed.
  
  
  METHODS
  The incidence of stroke, transient ischaemic attack, and myocardial infarction in the early postoperative period was analysed.
  
  
  RESULTS
  Myocardial revascularisation was successful in all 64 patients. There were no perioperative infarcts. In three patients (4.7%) a new neurological deficit developed postoperatively: two recovered fully before hospital discharge.
  
  
  CONCLUSIONS
  Combined coronary artery bypass graft surgery and carotid endarterectomy were performed safely and with good results.
authors.affiliation: Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London.
authors.forename: M
authors.initials: M
authors.lastname: Jahangiri
authors.forename: G M
authors.initials: GM
authors.lastname: Rees
authors.forename: S J
authors.initials: SJ
authors.lastname: Edmondson
authors.forename: J
authors.initials: J
authors.lastname: Lumley
authors.forename: R
authors.initials: R
authors.lastname: Uppal
mesh_terms: D000368:Aged; D000465:Algorithms; D016893:Carotid Stenosis / Q000601:surgery*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome