| Autor: |
Vassilidze, Teimouraz, Cernaianu, Aurel C., Gaprindashvili, Teimuraz, Gallucci, John G., Cilley Jr., Jonathan H., Grosso, Michael A., DelRossi, Anthony J. |
| Předmět: |
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| Zdroj: |
Vascular Surgery; Dec1994, Vol. 28 Issue 9, p577-580, 4p, 2 Charts |
| Abstrakt: |
This study assessed the outcome of 11 consecutive high-risk patients (8 men, 3 women) with symptomatic, high-grade (greater than 70%) bilateral carotid stenosis and left main or triple-vessel disease with unstable angina undergoing emergency simultaneous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) revascularization. Seven patients presented with crescendo unstable angina and 4 had type III postinfarction unstable angina. All were symptomatic for cerebrovascular insufficiency. Six patients had left main and 5 patients had triple-vessel disease aside from bilateral carotid lesions. There were 8 men and 3 women, (mean age 69.1 ±3.9 years). The mean preoperative end-diastolic pressure and ejection fraction were 17.2 ±2.4 mm Hg and 35.3 ±6.9%, respectively. Sequential reconstruction of the carotid artery was followed by CABG with an average number of 3.1 ±0.3 grafts per patient. One patient had additional aortic valve replacement and 1 had an automatic implantable cardioverter defibrillator implanted. There was no operative mortality. The overall neurologic complication rate was 27.3% (3 of 11). One patient developed perioperative myocardial infarction and 1 other had respiratory failure. Mean postoperative hospital stay was 24.4 ±4.8 days. Within one year postoperation, 1 patient died. Two patients had contralateral CEA owing to recurrent transient ischemic attack. The five-year probability of survival was 89%. Our data show that simultaneous CEA/CABG in patients with high-risk coronary and cerebrovascular insufficiency may result in low mortality; however, a relatively increased incidence of short- and long-term morbidity is expected. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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