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West Ashley Library
9 a.m. - 6 p.m.
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Edgar Allan Poe/Sullivan's Island Library
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Wando Mount Pleasant Library
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Phone: (843) 805-6888
Village Library
9 a.m. - 6 p.m.
Phone: (843) 884-9741
St. Paul's/Hollywood Library
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Heart surgery and simultaneous carotid endarterectomy – 10-years single-center experience.
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- Author(s): Gerfer, Stephen; Ivanov, Borko; Krasivskyi, Ihor; Djordjevic, Ilija; Gaisendrees, Christopher; Avgeridou, Soi; Kuhn-Régnier, Ferdinand; Mader, Navid; Rahmanian, Parwis; Kröner, Axel; Kuhn, Elmar; Wahlers, Thorsten
- Source:
Perfusion. Nov2023, Vol. 38 Issue 8, p1617-1622. 6p. - Source:
- Additional Information
- Subject Terms: HEART valve surgery; CARDIAC surgery; HYPERTENSION; NEUROLOGICAL disorders; OVERLAPPING surgery; STROKE; TRANSIENT ischemic attack; CORONARY artery bypass; CAROTID endarterectomy; CAROTID artery stenosis; TIME; RETROSPECTIVE studies; ACQUISITION of data; SURGICAL complications; RISK assessment; TREATMENT effectiveness; CORONARY artery disease; MYOCARDIAL revascularization; MEDICAL records; DESCRIPTIVE statistics; POSTOPERATIVE period; MEDICAL history taking; BODY mass index; SMOKING; LONGITUDINAL method; DISEASE risk factors; DISEASE complications
- Abstract: Background: Patients with coronary artery heart disease frequently suffer concomitant carotid vascular disease and are at high perioperative risk for neurological adverse events. Several concepts regarding the timing and modality of carotid revascularization are controversially discussed in patients with heart disease. Current guidelines recommendations on myocardial revascularization recommend a concomitant carotid endarterectomy (CEA) in patients with a history of stroke/transient ischemic attack (TIA) or 50–99% grade of the carotid stenosis. Our study aimed to analyze early outcome parameters of patients undergoing coronary artery bypass grafting (CABG), but also including concomitant heart valve surgery and simultaneous CEA. Methods: This study retrospectively analyzed a cohort of 111 patients from our institutional database undergoing heart surgery with CABG or heart-valve surgery between 2010 and 2020 with concomitant carotid surgery due to significant carotid stenosis. Results: Patients undergoing heart and simultaneous carotid surgery were 77 ± 8.0 years of age with a body mass index of 28 ± 1.7 kg/m2 and a mean EuroSCORE II of 6.5 ± 2.3. Most patients (61%) had a smoking history and arterial hypertension (97%). The preoperative mean grade of internal carotid stenosis was 87 ± 4.2%, 13% of patients suffered from internal carotid artery stenosis on both sites. In total, 4.5% of patients had previously undergone internal carotid artery intervention before and 6.3% had a history of stroke with a persistent neurologic disorder in 1.8%, 8.9% of cases had prior TIA. Thirty-day all-cause mortality was 6.3% and postoperative neurologic events occurred with 7.2% TIA and 4.5% of disabling stroke. Conclusion: Within the reported patient population of coronary artery heart disease and significant internal carotid stenosis, a one-time approach with CABG or heart-valve surgery and CEA is safe and feasible as justified by clinical and neurological postoperative outcomes. [ABSTRACT FROM AUTHOR]
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