Perioperative Morbidity and Mortality in Combined vs. Staged Approaches to Carotid and Coronary Revascularization

Giangola, Gary; Migaly, John; Riles, Thomas S.; Lamparello, Patrick J.; Adelman, Mark A.; Grossi, Eugene A.; Colvin, Stephen B.; Pasternak, Peter F.; Galloway, Aubrey C.; Culliford, Alfred T.; Esposito, Giovanni; Ribacove, Gregory; Crawford, Bernard; Glassman, Lawrence; Baumann, F.Gregory; Spencer, Frank C.

doi:10.1007/bf02000757

Cited by 43 publications

(19 citation statements)

References 21 publications

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“…Another interesting piece of data was the frequency of contralateral stroke, which may account for up to 50% of all postoperative stroke, emphasizing the likelihood of other causes for these neurological complications, such as aortic or cardiogenic embolism, intracranial hemorrhage, and reduced cerebral perfusion associated with arterial hypotension 27 .…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, permanent stroke was previously diagnosed in about 20% of the patients in some series 16,18,26,27 . The degree of carotid lesion was also studied.…”

Section: Patients' Clinical Profilementioning

confidence: 99%

“…Risk of perioperative stroke increases nearly three-fold in patients with history of cerebrovascular ischemia 31 . With the combined approach, these rates drop to around 10% for neurological lesions 26,27,[39][40][41][42][43][44] . Other major risk factors for neurological damage following CABG include advanced age and prolonged ECC time 45 .…”

Section: Surgical Indication and Techniquementioning

confidence: 99%

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Procedimento combinado entre operação de revascularização do miocárdio e endarterectomia de carótida: análise dos resultados

Lucas

Bonamigo

Weber

et al. 2005

Arq. Bras. Cardiol.

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Section: Resultsmentioning

confidence: 99%

“…Moreover, permanent stroke was previously diagnosed in about 20% of the patients in some series 16,18,26,27 . The degree of carotid lesion was also studied.…”

Section: Patients' Clinical Profilementioning

confidence: 99%

Section: Surgical Indication and Techniquementioning

confidence: 99%

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Procedimento combinado entre operação de revascularização do miocárdio e endarterectomia de carótida: análise dos resultados

Lucas

Bonamigo

Weber

et al. 2005

Arq. Bras. Cardiol.

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“…The incidence of peri-operative stroke, on the other hand, is markedly increased in patients with ≥ 80% carotid artery stenosis, suggesting a staged approach, including CABG followed by CEA 27. However, the incidence of cardiovascular accidents is mainly associated with embolism rather than low cardiac-output thrombosis rate in patients undergoing elective CABG surgery 28…”

Section: Discussionmentioning

confidence: 99%

Simultaneous coronary artery bypass grafting and carotid endarterectomy can be performed with low mortality rates : cardiovascular topic

Aydın¹,

Özen²,

Sarikaya³

et al. 2014

CVJA

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SummaryIntroductionThere is controversy over the best approach for patients with concomitant carotid and coronary artery disease. In this study, we report on our experience with simultaneous carotid endarterectomy (CEA) and coronary artery bypass graft (CABG) surgery in our clinic in the light of data in the literature.MethodsBetween January 1996 and January 2009, a total of 110 patients (86 males, 24 females; mean age 65.11 ± 7.81 years; range 44–85 years), who were admitted to the cardiovascular surgery clinic at our hospital, were retrospectively analysed. All patients underwent simultaneous CEA and CABG. Demographic characteristics of the patients and a history of previous myocardial infarction (MI), hypertension, diabetes mellitus, hyperlipidaemia, peripheral arterial disease and smoking were recorded.ResultsOne patient (0.9%) with major stroke died due to ventricular fibrillation. Peri-operative neurological complications were observed in seven patients (6%). Complications were persistent in two patients. Four patients (3%) had postoperative major stroke, whereas three patients (2%) had transient hemiparesis. No peri-operative myocardial infarction was observed.ConclusionSimultaneous CEA and CABG can be performed with low rates of mortality and morbidity.

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“…Clinically, this manifests as MI in patients undergoing CEA, with rates of MI as high as 17% in patients with severe CAD, or stroke in patients undergoing CABG, with rates as high as 20% in the setting of severe bilateral carotid disease [92,93]. Many studies of combined CEA and CABG have been performed, with widely varying results, and same reported rates of cumulative adverse events (stroke, MI and death) as high as 27% [92,[94][95][96][97][98][99]. With the advent of carotid artery stenting (CAS) with distal embolic protection devices, there has been interest in combined CAS and CABG procedures to mitigate the risks associated with a combined surgical approach.…”

Section: Co-existing Carotid and Cadmentioning

confidence: 99%

Hybrid cardiovascular therapy: interventional (and surgical) procedures in high-risk patients

Muhammad¹,

Helton²,

Theodos³

et al. 2011

Interventional Cardiology

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REVIEWCardiovascular consultants are increasingly faced with patients presenting with multiple comorbidities or structural challenges, who are in need for anatomical corrections. In such patients, hybrid cardiovascular procedures often allow for collaborative therapies that integrate the strengths of percutaneous and traditional open surgical treatments, to provide an overarching treatment that cannot be provided by either approach in isolation. While the concept of hybrid cardiovascular therapy is not new, it has seen a resurgence in recent years, with the developement of new devices and approaches. Areas of particular growth within hybrid cardiovascular care include hybrid myocardial revascularization, hybrid therapies for valvular and structural heart diseases and hybrid procedures for aortic diseases. Future growth in this field is inevitable and represents an exciting frontier in cardiovascular medicine.Keywords: aortic aneurysm n aortic dissection n hybrid procedures n myocardial revascularization n paravalvular leak n post-infarction ventricular septal rupture n valve replacement

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Perioperative Morbidity and Mortality in Combined vs. Staged Approaches to Carotid and Coronary Revascularization

Cited by 43 publications

References 21 publications

Procedimento combinado entre operação de revascularização do miocárdio e endarterectomia de carótida: análise dos resultados

Procedimento combinado entre operação de revascularização do miocárdio e endarterectomia de carótida: análise dos resultados

Simultaneous coronary artery bypass grafting and carotid endarterectomy can be performed with low mortality rates : cardiovascular topic

Hybrid cardiovascular therapy: interventional (and surgical) procedures in high-risk patients

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