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Simultaneus carotid and cardiac operations

Introduction: The results of concomitant carotid endarterectomy with cardiac operation vary be tween institutions. Indications for such procedures are still under discussion. Aim: We reviewed our results of carotid endarterectomy and cardiac surgery done as a simultane ous procedure. Methods: Between January 2008 and September 2018, 75 patients underwent a simultaneous car diac operation (Coronary Artery Bypass - CABG, valve replacement or both) and carotid endarter ectomy (CEA). There were 33 males and 27 females. Mean age was 69.05 years. Carotid stenosis was >90% in 33 patients and 70-89% in 40 patients. Sixty patients had asymptomatic carotid stenosis and 15 had either TIA or stroke. Results: CEA was performed using a Dacron patch in 66 patients and autologous vein was used in two patients. In seven cases eversion TEA was done. Intraoperative shunt was used in 31 patients. Only six procedures were done "off-pump". Perioperative TIA was registered in three patients and five patients suffered a stroke. Local complications (neck hematoma) occurred in 10 patients, but only five needed an additional procedure. One patient had a perioperative myocardial infarction and in seven patients pneumonia was diagnosed. One patient died postoperatively. Conclusions: Simultaneous carotid endarterectomy with cardiac surgery is a safe and effective pro cedure in patients with significant carotid disease.

simultaneus carotid and cardiac operations

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