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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
1979-1-26
pubmed:abstractText
Between 1969 and 1976, 174 patients were treated surgically for simultaneous carotid and coronary atherosclerosis. In 59 patients, staged carotid endarterectomy was performed a few days to 6 months prior to myocardial revascularization. Severe (more than 60% stenosis) coronary atherosclerosis affected a single vessel in 11 patients (19%), two vessels in 20 patients (34%), and three vessels in 28 patients (47%). Left ventricular contraction was impaired in 30 patients (51%). Nine patients (15%) had previous neurological symptoms, and 50 patients (85%) had asymptomatic carotid stenosis. One patient (1.5%) had a permanent stroke after carotid endarterectomy. There were no permanent strokes after staged myocardial revascularization, and the early mortality rate was 1.7%. Combined carotid endarterectomy and myocardial revascularization were performed in 115 patients with severe cardiac disease. Coronary atherosclerosis affected a single vessel in 10 patients (9%), two vessels in 39 patients (34%), and three vessels in 66 patients (57%). Left ventricular impairment was present in 72 patients (63%). Thirty-five patients (30%) had previous neurological symptoms, and 80 patients (70%) had asymptomatic carotid stenosis. Five patients (4.3%) had permanent strokes after combined revascularization, and four of these patients had occlusion or severe stenosis of the contralateral internal carotid artery. The early mortality rate was 4.3%, but no deaths could be attributed to carotid repair. The results suggest that significant simultaneous carotid and coronary atherosclerosis should be corrected in selected patients by staged operations when feasible. In the presence of severe cardiac disease, a combined precedure may be performed in face of higher risk of intraoperative stroke.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
0039-6060
pubmed:author
pubmed:issnType
Print
pubmed:volume
84
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
803-11
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
1978
pubmed:articleTitle
Staged and combined surgical approach to simultaneous carotid and coronary vascular disease.
pubmed:publicationType
Journal Article