[Carotid endarterectomy combined with myocardial revascularization: report of 27 patients].
Atherosclerosis is a systemic disease that may involve more than one territory. Myocardial infarction can occur after carotid endarterectomy and stroke is a well documented morbidity of coronary artery bypass grafting. To optimize results, we have performed concomitant carotid endarterectomy and myocardial revascularization in selected cases, with severe disease in both territories. During a 13-year period, 27 patients were submitted for this procedure, 21 (77.8%) were male and the average age was 67.6 years (range 59-81). All patients had high-grade internal carotid artery stenosis, five (18.5%) were symptomatic. Coronary artery disease symptoms were: unstable angina in 12 patients (44.4%) and effort angina in 15 (55.6%). Two patients (7.4%) required reintervention for postoperative bleeding. Two cases (7.4%) had transient renal dysfunction. One patient, with multiple organ failure, died on the 16th postoperative day (3.7%). Follow up was obtained in 26 patients (96.3%). Survival at 5 years was 80.6%, 95.7% of those patients were free of any neurologic symptom. Combined carotid and coronary surgery is a safe treatment option for atherosclerosis of multiple territories in selected patients; long term benefits are also obtained.
Mertens
R
R
Departamento de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Valdés
F
F
Krämer
A
A
Morán
S
S
Zalaquett
R
R
Irarrázaval
M
M
Maturana
G
G
D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D003327:Coronary Disease / Q000601:surgery*; D018572:Disease-Free Survival; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012189:Retrospective Studies; D016896:Treatment Outcome