Comparative Results of Combined Coronary Artery Bypass Grafting and Carotid Endarterectomy versus Staged Operation.
10.4174/jkss.2011.80.1.61
- Author:
Yang Jin PARK
1
;
Dong Ik KIM
;
Young Nam ROH
;
Wook Sung KIM
;
Young Tak LEE
;
Gyeong Moon KIM
;
Duk Kyung KIM
;
Young Wook KIM
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ywkim@skku.edu
- Publication Type:Original Article
- Keywords:
Endarterectomy;
Carotid artery;
Coronary artery bypass
- MeSH:
Carotid Arteries;
Coronary Artery Bypass;
Coronary Vessels;
Demography;
Endarterectomy;
Endarterectomy, Carotid;
Humans;
Medical Records;
Myocardial Infarction;
Neurologic Manifestations;
Retrospective Studies;
Stroke
- From:Journal of the Korean Surgical Society
2011;80(1):61-66
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Between combined and staged operations of carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) for patients with concurrent coronary and carotid disease, each treatment strategy has its own advantages and disadvantages. We attempted to compare early surgical results between the two operations. METHODS: We retrospectively reviewed medical records of 71 patients who underwent either combined CEA & CABG (n=37) or staged CABG & CEA (n=34) in a single institute between January 2001 and March 2010. After comparing patients' demographics and preoperative neurologic and cardiac status, we compared early (<1 month) postoperative cardiac or neurologic complications and surgical mortality between the 2 groups. RESULTS: There was no significant difference in patients' demographics and indications for operation the between 2 groups. There were 2 (5.4%) cases of postoperative stroke in combined groups and 1 (2.9%) in staged group. However, there was no myocardial infarction or death. In staged operation group, during the interval time between the two operations, 5 cases (14.7%) of stroke developed, of which, all patients recovered without any sequelae by anticoagulation. CONCLUSION: After experiencing low postoperative cardiac or neurologic morbidity or mortality after combined CABG and CEA, we conclude that combined CABG and CEA was a safe and feasible treatment option for patients with neurologic symptoms and in stable cardiac status. In the staged operation group of patients, we observed development of neurologic events during the interval period between CABG and CEA. To attain optimal treatment strategy in asymptomatic patients, further prospective study would be required.
