HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Francis P. Sutter Scott M. Goldman Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Khaitan, L. Articles by Whitlark, J. D. Search for Related Content PubMed PubMed Citation Articles by Khaitan, L. Articles by Whitlark, J. D.

Ann Thorac Surg 2000;69:421-424
© 2000 The Society of Thoracic Surgeons

---

Original Articles

Simultaneous carotid endarterectomy and coronary revascularization

^a Main Line Cardiothoracic Surgeons, Lankenau Hospital, Wynnewood, Pennsylvania, USA

Address reprint requests to Dr Sutter, Main Line Cardiothoracic Surgeons, Lankenau Hospital, Medical Science Building, Suite 280, 100 Lancaster Ave, Wynnewood, PA 19066
e-mail: mlcts2220{at}aol.com

Background. Combined cardiac operation and carotid endarterectomy using our technique is an acceptable approach to simultaneous correction of both carotid and cardiac disease.

Methods. From August 1989 to March 1998, 121 consecutive patients underwent combined operations. Of these patients, 112 had coronary artery bypass grafting and carotid endarterectomy, and 9 had coronary artery bypass grafting, carotid endarterectomy, and valve repair or replacement. All patients had a critical stenosis of 85% or more of the carotid artery. Mean age of the patients was 69.2 years; 80 patients were 65 years old or older. There were 88 men and 33 women. Notable risk factors included chronic obstructive pulmonary disease (19.8%), congestive heart failure (28%), preoperative myocardial infarction and unstable angina (66.9%). Of the patients, 20.7% had a stenosis of greater than 50% of the left main coronary artery. The technique used was correction of both the carotid and coronary lesions during a single aortic cross-clamp period using retrograde continuous blood cardioplegia for myocardial protection. Systemic hypothermia to 25°C was used for cerebral protection.

Results. Mean cross-clamp time was 118 minutes. Seven patients (5.8%) sustained perioperative cerebrovascular accidents. Two patients had transient ischemic attacks. The procedure-related mortality rate was 5.8%.

Conclusions. The described technique is a good method for simultaneous repair of coronary and carotid lesions in a high-risk group of patients with concomitant disease. We will continue to use it.

This article has been cited by other articles:

				E. Levy, D. Yakubovitch, E. Rudis, H. Anner, G. Landsberg, Y. Berlatzky, and A. Elami The role of combined carotid endarterectomy and coronary artery bypass grafting in the era of carotid stenting in view of long-term results Interact CardioVasc Thorac Surg, December 1, 2012; 15(6): 984 - 988. [Abstract] [Full Text] [PDF]

				M. M.-M. Sadeghi and A. M.-M. Sadeghi Coronary artery bypass and carotid endarterectomy with mild hypothermia Asian Cardiovascular and Thoracic Annals, April 1, 2012; 20(2): 168 - 171. [Abstract] [Full Text] [PDF]

				C. W. Akins and R. P. Cambria Myocardial Revascularization with Carotid Artery Disease , January 1, 2008; 3(2008): 655 - 668. [Full Text]

				L. Nwakanma, H. K. Poonyagariyagorn, R. Bello, A. Khoynezhad, D. Smego, and K. A. Plestis Early and late results of combined carotid endarterectomy and coronary artery bypass versus isolated coronary artery bypass Interact CardioVasc Thorac Surg, April 1, 2006; 5(2): 159 - 165. [Abstract] [Full Text] [PDF]

				C. W. Akins, A. D. Hilgenberg, G. J. Vlahakes, J. C. Madsen, T. E. MacGillivray, G. M. LaMuraglia, and R. P. Cambria Late Results of Combined Carotid and Coronary Surgery Using Actual Versus Actuarial Methodology Ann. Thorac. Surg., December 1, 2005; 80(6): 2091 - 2097. [Abstract] [Full Text] [PDF]

				C. W. Akins and A. C. Moncure Myocardial Revascularization with Carotid Artery Disease , January 1, 2003; 2(2003): 627 - 637. [Full Text]

				A. Zacharias, T. A. Schwann, C. J. Riordan, P. M. Clark, B. Martinez, S. J. Durham, M. Engoren, and R. H. Habib Operative and 5-year outcomes of combined carotid and coronary revascularization: review of a large contemporary experience Ann. Thorac. Surg., February 1, 2002; 73(2): 491 - 497. [Abstract] [Full Text] [PDF]

				P. E. Antunes, G. Anacleto, J. M. Ferrao de Oliveira, L. Eugenio, and M. J. Antunes Staged carotid and coronary surgery for concomitant carotid and coronary artery disease Eur J Cardiothorac Surg, February 1, 2002; 21(2): 181 - 186. [Abstract] [Full Text] [PDF]