title: Simultaneous approach of internal carotid artery revascularization at the base of the skull and coronary arteries bypass without extracorporeal circulation.
abstract: The best surgical approach for the treatment of patients with severe cerebral artery disease and simultaneous serious coronary artery disease remains controversial. In this report, we present a case of a 65-year-old man admitted to the hospital with unstable angina. Triple coronary artery obstructive disease and severe right internal carotid artery stenosis in the retroparotid region were diagnosed. A combined, simultaneous surgical procedure was performed. A lesion located in the retroparotid space required an approach by a presternocleidomastoid cervicotomy extended distally. Venous grafting of the internal carotid artery was performed. After carotid reconstruction, the three coronary arteries were revascularized without extracorporeal circulation. The patient showed a satisfactory postoperative outcome.
authors.affiliation: Department of Cardiovascular Surgery, West Georgian National Centre of Interventional Medicine, 83 Javakishvili St., Kutaisi, Georgia 4600. gaga_keshelava@yahoo.com
authors.forename: Grigol
authors.initials: G
authors.lastname: Keshelava
authors.forename: Kakha
authors.initials: K
authors.lastname: Beselia
authors.forename: Merab
authors.initials: M
authors.lastname: Nachkepia
authors.forename: Giorgi
authors.initials: G
authors.lastname: Janashia
authors.forename: Kakha
authors.initials: K
authors.lastname: Nuralidze
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000209:etiology / Q000601:surgery; D017536:Carotid Artery, Common / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008297:Male; D012501:Saphenous Vein / Q000601:surgery; D012720:Severity of Illness Index; D019291:Skull Base; D056346:Sternotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D058017:Vascular Grafting