title: [Common factors for ischemic cerebral stroke in coronary artery bypass grafting in patients with concomitant carotid and coronary artery severe stenosis].
abstract: To analyze two common factors for perioperative ischemic stroke in patients with concomitant carotid and coronary artery severe stenosis and to improve the therapeutic effect.  Methods: A total of 44 patients with multi-vessel coronary artery disease combined with carotid stenosis, who admitted to the Department of Cardiac Surgery, the First Affiliated Hospital of Xiamen University from 2008 to 2014, were enrolled in this study. Among them, 32 cases were male, 12 cases was female. All patients received coronary artery bypass grafting after treatment of neck diseases. The surgical outcomes and follow-up results were analyzed retrospectively.  Results: One patient received carotid endarterectomy suffered hemiplegia, whose symptoms were improved after positive clinical treatment. One patient suffered transient ischemic attack, and 5 patients displayed the cerebrovascular syndromes a week later after surgery. Twelve patients suffered nerve function damage 48 hours later after surgery. Nine patients received intra-aortic ballon pump, 1 patient received thoracotomy hemostasis, 3 patients suffered sternal dehiscence; 27 patients showed atrial fibrillation. Two patients died after surgery. The follow-up duration ranged from 1-7 years and the follow-up rate was 90%. The ischemic symptoms were improved in 44 patients. Six patients complained the recurrence of angina, but no abnormalities were found in coronary angiography or computed tomography angiography. One patient died of malignant tumor during the follow-up duration.  Conclusion: For patients with concomitant carotid and coronary artery severe stenosis, it is more likely to suffer ischemic cerebral stroke. However, carotid stenosis is not the only factor, other key factors relevant to ischemic cerebral stroke shouldn't be ignored either.
authors.affiliation: Department of Cardiovascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Cardiac Surgery, First affiliated Hospital of Xiamen University, Xiamen Fujian 361000, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Kuang
authors.affiliation: Department of Cardiac Surgery, First affiliated Hospital of Xiamen University, Xiamen Fujian 361000, China.
authors.forename: Zhonggui
authors.initials: Z
authors.lastname: Shan
authors.affiliation: Department of Cardiac Surgery, First affiliated Hospital of Xiamen University, Xiamen Fujian 361000, China.
authors.forename: Yiquan
authors.initials: Y
authors.lastname: Lai
authors.affiliation: Department of Cardiac Surgery, First affiliated Hospital of Xiamen University, Xiamen Fujian 361000, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Guo
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016893:Carotid Stenosis / Q000150:complications* / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015897:Comorbidity; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality*; D003324:Coronary Artery Disease / Q000150:complications* / Q000601:surgery*; D023921:Coronary Stenosis / Q000150:complications* / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D005260:Female; D006429:Hemiplegia / Q000453:epidemiology; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects; D007431:Intraoperative Complications / Q000453:epidemiology*; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D009422:Nervous System Diseases; D059348:Peripheral Nerve Injuries / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D013908:Thoracotomy / Q000009:adverse effects