One-Stage Surgical Correction in Case of Combined Lesions of the Carotid and Coronary Arteries

The aim of the work is to determine the most effective and safe approach to treatment of patients with combined pathologies of the carotid and coronary arteries. For the period from 2006 to 2016 in the RSPC “Cardiology” was operated on 207 patients with concomitant pathologies of the carotid and coronary arteries. Clinical data of patients included: angina of FC III, chronic heart failure NYHA III, one – or 2-sided lesions of the internal carotid artery, chronic arterial insufficiency of the lower extremities, diabetes mellitus, chronic kidney disease. Оne-stage correction was performed in patients in cases of concominant pathology of carotid and coronary arteries to reduce the number of perioperative complications and mortality: carotid endarterectomy combined with heart operation. Coronary artery bypass grafting was supplemented by correction of the valvular apparatus and/or left ventricular aneurysm plasty in identifying the relevant evidence. We have analyzed the results of surgical correction of abnormalities of the coronary and carotid arteries combined with their defeat. It was shown the safety and effectiveness of tactical approach in the group of concomitant lesions in both arterial basins. Mortality and postoperative complications did not exceed those in patients operated just about ischemic heart disease (mortality of 2.9 %). This fact allows the authors to make a conclusion about the legality of the use of this tactic, with good immediate results. A positive result is obtained with the simultaneous approach in the treatment of patients with coronary artery disease and pathology of the carotid artery