Combined carotid and cardiac procedures

Improved results and surgical approach

F. Donatelli, S. Pelenghi, M. Pocar, A. Moneta, A. Grossi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Severe cerebrovascular complications following cardiac surgical procedures remain a major concern, particularly in patients with significant carotid atherosclerotic involvement (14% of perioperative stroke). Operative mortality for carotid operations in patients with documented Coronary Artery Disease (CAD) may be as high as 20%. Seventy patients underwent combined operations (unilateral carotid stenosis > 70%, unilateral stenosis > 50% with ulcerated plaque or bilateral stenoses > 50%; and this also included patients with unilateral occlusion). Cardiac procedures were 69 coronary artery bypass grafts, four left ventricular aneurysmectomies, three aortic valve replacements and surgery on two mitral valves. Seven perioperative deaths occurred, which were all caused by cardiac events. There were no perioperative strokes. Carotid endarterectomy immediately before cardiopulmonary bypass is a safe and expeditious approach to coexisting significant cardiac and carotid disease. In our experience, technical details in monitoring and minimizing cerebral ischemia are possibly more crucial in these severe vasculopathic patients. Moreover, it is probably advantageous from an economic standpoint compared with other therapeutic treatments.

Original languageEnglish
Pages (from-to)506-510
Number of pages5
JournalCardiovascular Surgery
Volume6
Issue number5
DOIs
Publication statusPublished - Oct 1998

Fingerprint

Pathologic Constriction
Stroke
Cardiac Surgical Procedures
Carotid Endarterectomy
Carotid Stenosis
Brain Ischemia
Cardiopulmonary Bypass
Aortic Valve
Mitral Valve
Coronary Artery Bypass
Coronary Artery Disease
Heart Diseases
Economics
Transplants
Mortality
Therapeutics

Keywords

  • Carotid
  • Combined procedures
  • Myocardial revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Surgery

Cite this

Combined carotid and cardiac procedures : Improved results and surgical approach. / Donatelli, F.; Pelenghi, S.; Pocar, M.; Moneta, A.; Grossi, A.

In: Cardiovascular Surgery, Vol. 6, No. 5, 10.1998, p. 506-510.

Research output: Contribution to journalArticle

Donatelli, F. ; Pelenghi, S. ; Pocar, M. ; Moneta, A. ; Grossi, A. / Combined carotid and cardiac procedures : Improved results and surgical approach. In: Cardiovascular Surgery. 1998 ; Vol. 6, No. 5. pp. 506-510.
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