Document Detail


Simultaneous carotid endarterectomy and myocardial revascularization by using cardiopulmonary bypass for both procedures.
MedLine Citation:
PMID:  16385917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The optimal treatment of patients with co-existing occlusive coronary and carotid arterial disease is controversial. This study reports our experience with simultaneous carotid endarterectomy and coronary bypass in conjunction with cardiopulmonary bypass with mild hypothermia. METHODS AND RESULTS: From March 2001 to June 2004, 72 patients underwent simultaneous coronary bypass and carotid endarterectomy. Their mean age was 68.9 years and there were 56 men and 16 women. The indication for carotid endarterectomy was a lumen diameter reduction of more than 75% and/or the presence of ulcerated/unstable plaque. Carotid endarterectomy was done during cardiopulmonary bypass under mild hypothermia, haemodilution, systemic heparinization and controlled haemodynamics under pulsatile perfusion for additional cerebral protection. The mean cardiopulmonary bypass time was 64.7 minutes and aortic cross-clamp time 32.4 minutes, and the mean number of grafts per patient was 2.7. Four patients had perioperative neurological complications (5.5%) and two had permanent deficits (2.7%). The procedure-related mortality was 3 (4.1%). CONCLUSIONS: We suggest that combining coronary revascularization and carotid endarterectomy and performing both under cardiopulmonary bypass is safe, offering acceptable morbidity and mortality rates.
Authors:
Tekin Yildirim; Cengiz Koksal; Hakan Kiniklioglu; Sinan Arsan
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  60     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-02     Completed Date:  2006-01-26     Revised Date:  2009-06-11    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  575-9     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Goztepe Safak Hospital, Istanbul, Turkey. ty@ttnet.net.tr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiopulmonary Bypass / methods*,  mortality
Carotid Stenosis / complications,  surgery
Cohort Studies
Combined Modality Therapy
Coronary Artery Bypass / methods*,  mortality
Coronary Stenosis / complications,  surgery
Endarterectomy, Carotid / methods*,  mortality
Female
Humans
Male
Middle Aged
Postoperative Complications / diagnosis,  mortality*
Prognosis
Retrospective Studies
Risk Assessment
Survival Rate
Treatment Outcome
Turkey

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


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