HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Minami, K. Articles by Korfer, R. Search for Related Content PubMed PubMed Citation Articles by Minami, K. Articles by Korfer, R.

The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 303-309, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Operative strategy in combined coronary and carotid artery disease

K Minami, KS Sagoo, T Breymann, D Fassbender, M Schwerdt and R Korfer
Department of Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Bad Oeynhausen, Federal Republic of Germany.

In the period between the opening of our heart center in November 1984 and May 1986, 2001 cardiac operations were performed with the aid of cardiopulmonary bypass. Almost three quarters (73.5%, n = 1471) of the patients had coronary artery disease and 20% (n = 359) had acquired valvular heart disease. In 47 of 1471 patients who underwent coronary artery bypass grafting, a simultaneous carotid endarterectomy was performed. They included 36 men and 11 women, aged between 51 and 78 years (mean 64 years). Preoperatively, 12 patients had cerebrovascular symptoms and 35 were neurologically asymptomatic. Twenty-three had unilateral carotid stenosis and 24 had bilateral or multiple vessel disease of the extracranial arteries. All except four patients had triple-vessel coronary artery disease. In three patients with aortic valve disease, coronary bypass, carotid endarterectomy, and aortic valve replacement were performed simultaneously. Cardiopulmonary bypass was instituted before carotid endarterectomy was performed, with mild hypothermia and hemodilution for added protection. Electroencephalographic monitoring was used throughout the operation. Forty-six of the 47 patients survived the operation without neurologic or cardiac complications. One patient had a neurologic deficit with hemiplegia and coma, which was lethal. We conclude that simultaneous endarterectomy of significant extracranial artery stenosis in candidates for coronary bypass is a method safe enough to justify its routine use.

This article has been cited by other articles:

				S. Tanimoto, Y. Ikari, K. Tanabe, S. Yachi, H. Nakajima, T. Nakayama, M. Hatori, G. Nakazawa, Y. Onuma, Y. Higashikuni, et al. Prevalence of Carotid Artery Stenosis in Patients With Coronary Artery Disease in Japanese Population Stroke, October 1, 2005; 36(10): 2094 - 2098. [Abstract] [Full Text] [PDF]

				K. Minami, K. Fukahara, D. Boethig, A. Bairaktaris, D. Fritzsche, and R. Koerfer LONG-TERM RESULTS OF SIMULTANEOUS CAROTID ENDARTERECTOMY AND MYOCARDIAL REVASCULARIZATION WITH CARDIOPULMONARY BYPASS USED FOR BOTH PROCEDURES J. Thorac. Cardiovasc. Surg., April 1, 2000; 119(4): 764 - 772. [Abstract] [Full Text] [PDF]

				H. L. Lazar and J. O. Menzoian Coronary artery bypass grafting in patients with cerebrovascular disease Ann. Thorac. Surg., September 1, 1998; 66(3): 968 - 974. [Abstract] [Full Text] [PDF]

				P. O. Daily, R. K. Freeman, W. P. Dembitsky, R. M. Adamson, R. J. Moreno-Cabral, S. Marcus, and J. A. Lamphere COST REDUCTION BY COMBINED CAROTID ENDARTERECTOMY AND CORONARY ARTERY BYPASS GRAFTING J. Thorac. Cardiovasc. Surg., June 1, 1996; 111(6): 1185 - 1193. [Abstract] [Full Text]

				W. S. Moore, H.J.M. Barnett, H. G. Beebe, E. F. Bernstein, B. J. Brener, T. Brott, L. R. Caplan, A. Day, J. Goldstone, R. W. Hobson II, et al. Guidelines for Carotid Endarterectomy : A Multidisciplinary Consensus Statement From the Ad Hoc Committee, American Heart Association Circulation, January 15, 1995; 91(2): 566 - 579. [Abstract] [Full Text]

				W. S. Moore, H.J.M. Barnett, H. G. Beebe, E. F. Bernstein, B. J. Brener, T. Brott, L. R. Caplan, A. Day, J. Goldstone, R. W. Hobson II, et al. Guidelines for Carotid Endarterectomy : A Multidisciplinary Consensus Statement From the Ad Hoc Committee, American Heart Association Stroke, January 1, 1995; 26(1): 188 - 201. [Abstract] [Full Text]