title: Early results of synchronous carotid endarterectomy and off-pump coronary revascularization.
abstract: OBJECTIVE
  This study reports results of synchronous carotid endarterectomy (CEA) and off-pump coronary artery bypass grafting (CABG) in further support of the hypothesis that carotid and coronary artery revascularization can be safely performed in most patients.
  
  
  METHODS
  The series includes 74 consecutive patients underwent synchronous CEA and off-pump CABG (group A) compared with 50 patients undergoing synchronous CEA and on-pump CABG (group B). Primary endpoint of this study are death, stroke, perioperative myocardial infarction and need for repeated revascularization within 30 days of the procedures. The secondary endpoint includes local and systemic complications.
  
  
  RESULTS
  No stroke was observed in group A. Ipsilateral minor stroke occurred in two patients of group B (4%). Two deaths within 30 days were observed in group A (2.7%) compared with 4 deaths in group B (8%). Combined stroke/death rate at 30 days was 2.7% in group A compared with 12% in group B (P< 0.05). No significant differences in myocardial infarction, local and systemic complications were observed.
  
  
  CONCLUSIONS
  Synchronous CEA and off-pump CABG may reduce the high surgical risk of patients who actually require combined carotid and coronary revascularization. This opinion has to be substantiated by larger studies and randomized trial.
authors.affiliation: Department of Cardiovascular Sciences, European Hospital, Rome, Italy. raoulborioni@alice.it
authors.forename: R
authors.initials: R
authors.lastname: Borioni
authors.forename: L
authors.initials: L
authors.lastname: Weltert
authors.forename: R
authors.initials: R
authors.lastname: De Paulis
authors.forename: A
authors.initials: A
authors.lastname: Bellisario
authors.forename: D
authors.initials: D
authors.lastname: Maselli
authors.forename: F
authors.initials: F
authors.lastname: Tomai
authors.forename: M
authors.initials: M
authors.lastname: Garofalo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome