| A single-stage procedure for carotid endarterectomy and myocardial revascularization: early and late results. | |
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MedLine Citation:
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PMID: 16392204 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiac events are some of the most frequent postoperative complications of carotid endarterectomy, while cerebrovascular accidents frequently occur in patients who have undergone coronary artery bypass grafting. The strategy for treatment of combined carotid and coronary artery disease is still controversial. We report our experience with a single-stage procedure for carotid endarterectomy and myocardial revascularization during cardiopulmonary bypass; then we evaluate our early and late results. From January 1994 through December 2001, 73 patients underwent combined myocardial revascularization and carotid endarterectomy in a single-stage procedure. Three patients (4.1%) died during the early postoperative period. Five patients (6.8%) showed temporary neurologic complications, while 1 patient (1.4%) had cerebrovascular accidents with late permanent neurologic deficit. At 5.5 +/- 2.1 years' follow-up (range: 2.6-10.4 years), 9 of the 70 surviving patients had died: 5 (71%) of cardiac-related events, 2 (2.9%) of cerebrovascular-related causes, and 2 (2.9%) of noncerebral or noncardiac causes. During the late postoperative period, 6 patients experienced cerebrovascular accidents, with a linearized rate of 2.3%/pt-yr (70% confidence interval: 1.5% to 3.2%/pt-yr), and 8 patients experienced cardiac-related events, with a linearized rate of 3.8%/pt-yr (70% confidence interval: 2.8% to 4.9%/pt-yr). A single-stage procedure for carotid endarterectomy and myocardial revascularization during cardiopulmonary bypass can be considered safe and effective when it incorporates systemic heparinization, hemodilution, and moderate hypothermia with pulsatile flow and normal blood pressure, which helps to preserve normal cerebrovascular autoregulatory mechanisms. |
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Authors:
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Luigi Di Tommaso; Gabriele Iannelli; Mario Monaco; Michele Mottola; Vincenzo De Amicis; Nicola Spampinato |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital Volume: 32 ISSN: 0730-2347 ISO Abbreviation: Tex Heart Inst J Publication Date: 2005 |
Date Detail:
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Created Date: 2006-01-05 Completed Date: 2006-01-24 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 8214622 Medline TA: Tex Heart Inst J Country: United States |
Other Details:
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Languages: eng Pagination: 271-6 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, University Federico II, Naples, Italy. iditommaso@tin.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiopulmonary Bypass Carotid Artery, Internal* Carotid Stenosis / complications, surgery* Coronary Stenosis / complications, surgery* Endarterectomy, Carotid / methods* Female Follow-Up Studies Humans Male Myocardial Revascularization / methods* Retrospective Studies Treatment Outcome |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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