Document Detail


Simultaneous carotid endarterectomy and cardiac surgery--additional risk factor or safety procedure?
MedLine Citation:
PMID:  12587084     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The occurrence of severe carotid artery disease in more than 12 % of patients requiring CABG results in a discrepancy concerning the best treatment for both diseases. We reviewed the early outcome of patients with CABG and/or valve replacement and simultaneous carotid endarterectomy (CEA). METHODS: We evaluated retrospectively 244 patients operated simultaneously between 7/94 and 10/2001. 209 patients received CABG; 35 patients CABG and/or valve replacement. Mean age was 68 years. 188 patients were male. We analyzed risk factors, morbidity, incidence of neurological complications and 30 day mortality. RESULTS: Perioperative stroke with hemiplegia occurred in 3.3 % (8 patients). 4 of these patients showed contralateral carotid artery occlusion, 2 contralateral severe stenosis. 2 patients (0.8 %) experienced prolonged reversible ischemic neurological deficit (PRIND), 4 patients (1.6 %) transient ischemic attack (TIA). 30-day lethality was 4.5 %. 3 patients died due to low cardiac output, 6 patients due to extracardial reasons, 2 patients (0.8 %) developed a cerebral death. CONCLUSIONS: Simultaneous CEA and cardiac surgery can be performed with an acceptable risk for neurological complications and mortality. Occlusion of contralateral carotid artery could be identified as an evident predictor for increased neurological complications. Compared to two-stage procedures, combined operations yield a reduction of hospital costs.
Authors:
B Gansera; I Angelis; J Weingartner; P Neumaier-Prauser; K Spiliopoulos; B M Kemkes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  51     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-14     Completed Date:  2003-07-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  22-7     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Klinikum Bogenhausen, Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiac Surgical Procedures / adverse effects*,  economics,  mortality
Carotid Artery Diseases / complications,  surgery
Coronary Artery Disease / complications,  surgery
Cost-Benefit Analysis
Endarterectomy, Carotid / adverse effects*,  economics,  mortality
Female
Heart Valve Diseases / complications,  surgery
Humans
Male
Middle Aged
Postoperative Complications*
Retrospective Studies
Risk Factors
Stroke / etiology*,  mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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