Early and late results of combined carotid endarterectomy and coronary artery bypass versus isolated coronary artery bypass

Nwakanma, Lois U.; Poonyagariyagorn, Hataya; Bello, Ricardo; Khoynezhad, Ali; Smego, Douglas; Plestis, Konstadinos A.

doi:10.1510/icvts.2005.114678

Cited by 19 publications

(16 citation statements)

References 26 publications

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“…Nwakanma et al 2 concluded that combined surgical treatment for carotid arteries and myocardial revascularization does not increase mortality and morbidity in short- and long-term follow-up when compared with isolated revascularization. The late follow-up data included myocardial infarction, stroke, and death.…”

Section: Introductionmentioning

confidence: 99%

Degree of Risk Related to Procedures Performed in Conjunction with Surgical Myocardial Revascularization in Octogenarians

Iglézias

Dallan

Lourenção

et al. 2009

Clinics

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INTRODUCTION/OBJECTIVES: We determined the degree of risk produced by the association of other surgical procedures with surgical myocardial revascularization in octogenarian patients and identified the risk factors that best explain hospital mortality. METHODS: This study was an observational analytical historical cohort study involving octogenarians operated on at our institution between January 1, 2000 and January 1, 2005. We stratified the objective population as follows: Group 1 comprised octogenarians revascularized without associated procedures, and Group 2 comprised octogenarians revascularized with associated procedures. Statistical analyses included the t test for independent samples and multiple logistic regression analysis. Significance was accepted with an alpha error of 5%. RESULTS: Univariate analyses revealed the following clinical and statistically significant variables: hospital mortality (P=0.002), diabetes mellitus (P=0.017), preoperative endocarditis (P=0.001), cardiogenic shock (P=0.019), use of an intra-aortic balloon pump (P=0.026), preoperative risk score (Parsonnet), P<0.001, procedure associated with revascularization (P<0.001), medium number of affected coronary arteries (P<0.001), use of extracorporeal circulation (P<0.001), time of extracorporeal circulation (P<0.001), number of distal anastomoses (P=0.002), graft type (P<0.001), postoperative breathing support (P<0.001), stroke (P<0.001), infection (P=0.002), creatinine level (P=0.018), and quality of life score (P=0.050). DISCUSSION/CONCLUSIONS: In octogenarian patients, the need for a procedure associated with surgical myocardial revascularization produces an absolute increase in hospital mortality risk of 45%. The variables that contributed to hospital mortality were preoperative endocarditis, preoperative cardiogenic shock, the use of extracorporeal circulation, the length of time of extracorporeal circulation, postoperative creatinine level, and postoperative need for prolonged respiratory support

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Section: Introductionmentioning

confidence: 99%

Degree of Risk Related to Procedures Performed in Conjunction with Surgical Myocardial Revascularization in Octogenarians

Iglézias

Dallan

Lourenção

et al. 2009

Clinics

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“…Totally 41,901 patients undergoing simultaneous or staged carotid and coronary procedures were collected from 53 reports (Evagelopoulos et al 2000;Snider et al 2000;Minami et al 2000;Gaudino et al 2001;Hamulu et al 2001;Youssuf et al 2001;Estes et al 2001;Farooq et al 2001;Bonacchi et al 2002;Bonardelli et al 2002;Antunes et al 2002;Zacharias et al 2002;Meharwal et al 2002;Roddy et al 2002;Char et al 2002;Beauford et al 2003;Brown et al 2003;Vitali et al 2003;Ricotta et al 2003;Srimahachota et al 2004;Mishra et al 2004;Ricotta et al 2005;Ziada et al 2005;Cinar et al 2005;Eren et al 2005;Chiappini et al 2005;Akins et al 2005;Nwakanma et al 2006;Inciura and Benetis 2006;Kolh et al 2006;Byrne et al 2006;Cywinski et al 2006;Kovacic et al 2006;Mendiz et al 2006;Randall et al 2006;Chiariello et al 2006;Hertzer and Mascha 2006;Madi-Jebara et al 2006;Kougias et al 2007;Dubinsky and Lai 2007;…”

Section: Resultsmentioning

confidence: 99%

Treatment Strategy for Combined Carotid Artery Stenosis and Coronary Artery Disease: Staged or Simultaneous Surgical Procedure?

Yuan

Hua

2009

Tohoku J. Exp. Med.

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“…Once happens, mortality of post-CABG stroke was reported to be 23.1%. Nwakanma et al [10] stated that adding CEA to CABG did not increase short and long term morbidity and mortality, and combined procedure can be done safely in this high risk group of patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy

Dönmez

Adademir

Saçlı

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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ObjectiveThis study aims to compare three different surgical approaches for combined coronary and carotid artery stenosis as a single stage procedure and to assess effect of operative strategy on mortality and neurological complications.MethodsThis retrospective study involves 136 patients who had synchronous coronary artery revascularization and carotid endarterectomy in our institution, between January 2002 and December 2012. Patients were divided into 3 groups according to the surgical technique used. Group I included 70 patients who had carotid endarterectomy, followed by coronary revascularization with on-pump technique, group II included 29 patients who had carotid endarterectomy, followed by coronary revascularization with off-pump technique, group III included 37 patients who had coronary revascularization with on-pump technique followed by carotid endarterectomy under aortic cross-clamp and systemic hypothermia (22-27ºC). Postoperative outcomes were evaluated.ResultsOverall early mortality and stroke rate was 5.1% for both. There were 3 (4.3%) deaths in group I, 2 (6.9%) deaths in group II and 2 (5.4%) deaths in group III. Stroke was observed in 5 (7.1%) patients in group I and 2 (6.9%) in group II. Stroke was not observed in group III. No statistically significant difference was observed for mortality and stroke rates among the groups.ConclusionWe identified no significant difference in mortality or neurologic complications among three approaches for synchronous surgery for coronary and carotid disease. Therefore it is impossible to conclude that a single principle might be adapted into standard practice. Patient specific risk factors and clinical conditions might be important in determining the surgical tecnnique.

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Early and late results of combined carotid endarterectomy and coronary artery bypass versus isolated coronary artery bypass

Cited by 19 publications

References 26 publications

Degree of Risk Related to Procedures Performed in Conjunction with Surgical Myocardial Revascularization in Octogenarians

Degree of Risk Related to Procedures Performed in Conjunction with Surgical Myocardial Revascularization in Octogenarians

Treatment Strategy for Combined Carotid Artery Stenosis and Coronary Artery Disease: Staged or Simultaneous Surgical Procedure?

Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy

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