Combined Surgical Treatment of Coronary and Carotid Artery Disease

Year 2012, , 107 - 110, 01.09.2012

Orhan Bozoğlan Bülent Meşe Kemalettin Erdem

https://doi.org/10.5505/abantmedj.2012.18291

Abstract

OBJECTIVE: Occurrence of myocardial infarction after carotid endarterectomy and cerebrovascular accident after myocardial revascularization procedures are both severe and frequent complications. In this study we aimed to present 22 patients who underwent combined carotid endarterectomy and coronary surgery procedure. METHODS: 22 patients who underwent combined carotid endarterectomy and coronary surgery procedure between June 2006 and July 2011 examined retrospectively also with early and mid-term results. Risk factors, mortality and uneventful survival rates were evaluated. Results: One patient died due to low cardiac output in the early postoperative period. A Minor neurologic event developed in another patient and resolved spontaneously. All patients included this one, discharged an average of 8±2 days postoperatively.RESULTS: In the combine procedure, average carotid clamp time was 25±7,8 min. and aortic cross clamp time was 48±12 min. The average length of stay in intensive care unit was 36±4,5 hours. Average hospital stay was 7,4±1,2 days. 90% of patients were followed clinically. During follow up period of 18±12.2 months no patients developed cardiac or neurological problems.CONCLUSION: In the presence of significant carotid stenosis in patients schedules for coronary bypass surgery, in these patients combined procedure can be applied with success.

Keywords

Carotid endarterectomy, coronary artery bypass, combined surgery

Koroner ve Karotis Arter Hastalığında Kombine Cerrahi Tedavi

Abstract

AMAÇ: Karotis arter endarterektomisi sonrası miyokard enfarktüsü, koroner arter bypass cerrahisi sonrası serebrovasküler olay son derece ciddi ve sık karşılaşılan komplikasyonlardır. Bu çalışmada koroner arterlere ve karotis arterine yönelik kombine girişim uygulanan 22 hastayı sunmayı amaçladık.YÖNTEMLER: Haziran 2006 ile Temmuz 2011 tarihleri arasında kombine koroner bypass ve karotis endarterektomi uygulanan 22 olgunun erken ve orta dönem mortalite, morbidite ve olaysız yaşam oranları retrospektif olarak değerlendirildi.BULGULAR: Erken postoperatif dönemde 22 olgu içerisinde bir olgu düşük kardiyak debi nedeniyle kaybedildi, bir olgu ise geçici minör nörolojik olay gelişti. Bu olgu ile birlikte tüm olgular postoperatif ortalama 8. günde taburcu edildi. Kombine cerrahide karotis arter kross klemp süresi ortalama için 25±7,8 dakika, aortik kross klemp süresi 48±12 dakika olarak gerçekleşti. Diğer tüm olgular yoğun bakımda ortalama 36±4.5 saat ve serviste ortalama 7.4±1.2 gün kaldıktan sonra taburcu edildiler. Olguların 18’i %90 klinik olarak 230 hasta ayı ortalama 18±12.2 ay izlenebildi. Bu süre boyunca hiçbir hastada kardiyak ve nörolojik mortalite ya da morbidite gelişmedi.SONUÇ: Koroner bypass planlanan ve anlamlı karotis arter darlığı tespit edilen ancak anstabil anjina pektorisi olan hastalara eş zamanlı karotis arter endarterektomisi başarı ile uygulanabilir.

Keywords

Karotis endarterektomi, koroner arter bypass, kombine cerrahi

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