Synchronous carotid stenting and cardiac surgery: an initial single-center experience.
Concurrent severe carotid and cardiac disease is a challenging situation where staged surgery is probably the most common strategy, although it is still controversial. We report in-hospital and midterm outcome of 30 patients who received carotid stenting and synchronous cardiac surgery. All received carotid stenting under aspirin and regular unfractioned heparin (UFH) and were immediately transferred to the operating room for coronary and/or cardiac valve surgery. All patients received aspirin and clopidogrel once bleeding was ruled out, after surgery. In-hospital complications were: three surgical related deaths, one TIA, and no patient suffered stroke or myocardial infarction. Hospital stay was 14 +/- 11.8 days. Survivors were followed for 18.4 +/- 14 months. There were two non-related deaths, but no stroke nor cardiac or carotid reinterventions. In conclusion, this small series showed that synchronous carotid stenting and cardiac surgery was feasible with an acceptable complication rate in a high-surgical-risk population which could not undergo staged procedures.
Mendiz
Oscar
O
Department of Interventional Cardiology, Fundación Favaloro, Buenos Aires, Argentina. omendiz@ffavaloro.org
Oscar
Mendiz
M
Fava
Carlos
C
Carlos
Fava
F
Valdivieso
León
L
León
Valdivieso
V
Dulbecco
Eduardo
E
Eduardo
Dulbecco
D
Raffaelli
Héctor
H
Héctor
Raffaelli
R
Lev
Gustavo
G
Gustavo
Lev
L
Favaloro
Roberto
R
Roberto
Favaloro
F
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D017536:Carotid Artery, Common / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome