[Simultaneous operations on the carotid and coronary arteries - the risk is due to?].
The article deals with the findings of a retrospective study regarding the incidence of risk factors for unfavourable outcomes during interventions on coronary arteries in patients presenting with atherosclerotic lesions of the carotid basin as compared to aortocoronary bypass grafting alone, followed by analysing individual risk factors. Also evaluated herein is the incidence rate of complications after coronary bypass grafting in patients presenting with various concomitant pathology, followed by determining the relative risk influencing hospital mortality both by groups as a whole and with due regard for stratification along the most significant risk factors. The study comprised a total of 74 patients with combined atherosclerotic lesions of carotid and coronary arteries, who were simultaneously subjected to revascularization of the myocardium and carotid basin. The control group was composed of 1,128 patients undergoing coronary bypass grafting alone. All patients were treated at the Federal Centre for Cardiovascular Surgery under the Russian Federation Ministry of Public Health and Social Development (Penza) from October 2008 to December 2011. The obtained findings confirmed the proposition that a simultaneous intervention of the CA does not increase the postoperative complications rate. The method of stratification demonstrated that the risk for the development of lethal outcomes in such patients turned out considerably higher. Patients with CA stenosis run higher risks of operational vascular complications, which is confirmed by a comparable level of mortality, cerebral strokes and myocardial infarction with the stratified group of patients having similar incidence of risk factors. Preventive interventions on the CA are aimed at decreasing operative complications and bring no additional risk to the lethality rate.
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Bazylev
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AE
Chernogrivov
A B
AB
Voevodin
D002339:Carotid Arteries / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*