The clinical outcomes comparison of combined versus staged approach on concomitant carotid and coronary severe stenosis patients
10.3760/cma.j.issn.1001-4497.2017.11.007
- VernacularTitle:颈动脉与冠状动脉并存重度狭窄的同期与分期手术临床疗效对比
- Author:
Xueqiang FAN
1
;
Peng LIU
;
Zhidong YE
;
Jianbin ZHANG
;
Fei WANG
;
Fan LIN
;
Yuguang YANG
;
Songyi QIAN
;
Yanan ZHEN
;
Jie CHEN
;
Xia ZHENG
;
Bo MA
;
Jinyong LI
;
Fenglin WANG
Author Information
1. 100029,北京中日友好医院心血管外科
- Keywords:
Carotid artery stenosis;
Coronary artery stenosis;
Combined approach;
Staged approach
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2017;33(11):673-676
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the outcome of combined and staged approach on concomitant carotid and coronary severe stenosis.Methods From March 2013 to May 2015,27 patients with concomitant carotid and coronary severe stenosis were treated by carotid endarterectomy and coronary artery bypass grafting,15 cases received one-stage operation and 12 staged.The basic characteristics,details during surgery,complications,quality of life score,hospital stay and cost were compared.Results 27 patients received carotid endarterectomy and off-pump coronary artery bypass grafting under general anesthesia.Revascularization were performed on 27 carotid and 82 coronary artery.The characteristics of patients were similar between two groups,reflected with WIC,combined approach subgroup was (5.27 ± 0.88) and staged subgroup was (4.92 ± 1.24).The operation time was significantly decreased in the synchronous group [(295.33 ± 49.73)min vs (390.83 ± 73.45) min,P ＜ 0.001].Hospital stay days was also reduced [(30.20 ± 12.91) days vs(44.67 ± 6.34) days,P =0.002],the medical cost was lower in combined approach group,but no significant statistical difference.The complications including 1 case TIA,1 recurrent nerve injury in one-stage group and 1 case myocardial infarction,1 mediastinal bleeding post-operation and 1 pulmonary infection in stage group.No cerebral infarction and death.Quality of life scores(SF-36) of the two groups was 5.53 ± 1.30 and 5.75 ± 1.36 respectively,no significant difference.Conclusion The efficacy and safety of treatment for concomitant carotid and coronary severe stenosis patients with combined or staged approach was similar.But the combined approach program can reduce the hospital stay time and cost in some degree.
