Concomitant coronary and asymptomatic carotid artery disease in patients prior to myocardial revascularization.
The authors report on the results of ultrasound examinations of the carotid arteries in 525 patients with ischemic heart disease, hospitalized at the Department of Cardiac Surgery in Hradec Králové, prior to myocardial revascularization. Only 213 patients (40.6%) had intact carotid bed. The remaining 312 patients (59.4%) were found to have asymptomatic sclerotic changes of varying degrees of severity. Haemodynamically significant stenoses of over 50% were found in 64 cases (12.2%). 19 patients (3.6%) had critical stenoses of over 85% or occlusions of one or both internal carotid arteries. Comparison between patients younger than 65 and older than 65 showed significant increase of sclerotic changes in the older group. The authors prefer to perform myocardial revascularization procedure in hypothermic CPB with alpha-stat regime before carotid artery surgery. Combined procedures are preferred only in cases with concomitant neurologic and coronary symptomatology or in cases with severe carotid stenoses or occlusions of both arteries.
Mand'ák
J
J
Department of Cardiac Surgery, University Hospital, Charles University Faculty of Medicine.
Lonský
V
V
Dominik
J
J
Harrerová
L
L
Brtko
M
M
D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000473:pathology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged