Document Detail

Bilateral carotid endarterectomy combined with myocardial revascularization during the same surgical act.
MedLine Citation:
PMID:  10967588     Owner:  NLM     Status:  MEDLINE    
The best surgical approach for the treatment of patients with severe cerebral artery disease and simultaneous serious coronary artery disease still remains controversial. In this report we present a case of a 72-year-old female patient admitted to the hospital with unstable angina. Triple coronary artery obstructive disease and severe bilateral carotid artery stenosis were diagnosed. A combined, simultaneous surgical procedure was performed. After total circulatory by-pass with a membrane oxygenator, the patient's body temperature was lowered to 32 degrees C. During the cool-down period, three proximal anastomoses of segments of autologous saphenous veins were performed in the ascending aorta. Immediately afterwards, bilateral carotid endarterectomy was performed, followed by three distal anastomoses to coronary arteries. The patient showed a satisfactory post-operative outcome. It was concluded that the combination of moderate hypothermia, hemodilution with appropriate hemodynamic control, as used in this patient, was an effective method of cerebral protection. The simultaneous approach of carotid endarterectomy and coronary artery by-pass surgery should be seen as a safe option for the treatment of this type of patient.
L A Mulinari; A L Tyszka; A Z Silva; F B Navarro; R G de Carvalho
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Arquivos brasileiros de cardiologia     Volume:  74     ISSN:  0066-782X     ISO Abbreviation:  Arq. Bras. Cardiol.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-10-04     Completed Date:  2000-10-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421031     Medline TA:  Arq Bras Cardiol     Country:  BRAZIL    
Other Details:
Languages:  eng     Pagination:  353-4     Citation Subset:  IM    
Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil.
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MeSH Terms
Carotid Stenosis / complications,  surgery*
Coronary Disease / complications,  surgery*
Endarterectomy, Carotid / methods*
Myocardial Revascularization / methods*
Treatment Outcome

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