What question did this study set out to answer?

To evaluate the early and late clinical outcomes, specifically death, myocardial infarction, and stroke, in patients undergoing concurrent surgical treatment for coexisting carotid and coronary artery disease.

January 1, 2000Cardiovascular Surgery

Simultaneous carotid endarterectomy and coronary artery bypass grafting in 313 patients

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Why the study?

What are the rates of death, myocardial infarction, and stroke following simultaneous carotid endarterectomy and coronary artery bypass grafting in patients with concomitant coronary and severe carotid artery disease?

Population

313 patients with a need for myocardial revascularization and symptomatic or asymptomatic carotid stenosis…

Design

Cohort

Follow-up

Mean survival time 6.18 years

Authors

NEN. EvagelopoulosDeutsches Herzzentrum der Charité

Discussion

Member takes

Implication

Acceptable perioperative risks support combined CEA-CABG feasibility in selected patients; leaves open randomized comparison to staged approaches.

Key Points

To evaluate the early and late clinical outcomes, specifically death, myocardial infarction, and stroke, in patients undergoing concurrent surgical treatment for coexisting carotid and coronary artery disease.
Retrospective review of N=313 consecutive patients (out of 18,050 cardiac surgeries) undergoing simultaneous carotid endarterectomy and coronary artery bypass grafting between 1990 and 1997.
Eligible patients required myocardial revascularization and presented with symptomatic or asymptomatic internal carotid artery stenosis of ≥80% diameter reduction.
Surgical technique involved carotid artery exposure, median sternotomy, cardiopulmonary bypass with mild hypothermia (30°C) for endarterectomy with venous patch closure, followed by bypass grafting under moderate hypothermia (22–27°C).
Perioperative complications (<30 days) included myocardial infarction in 3.2% (n=10), stroke in 2.2% (n=7), and early overall mortality in 8.9% (n=28; 4.2% cardiac-related).
Long-term outcomes included 1 late stroke (0.3%), an overall late mortality rate of 2.6% (n=8; 1.9% cardiac-related), and a mean survival time of 6.18 years.

Structured PICO

Population

313 patients with a need for myocardial revascularization and symptomatic or asymptomatic carotid stenosis of 80% diameter reduction or more (with or without contralateral disease). Mean age 66.4 +/- 6.9 years, 76.7% male.

Intervention

Simultaneous carotid endarterectomy and coronary artery bypass grafting

Outcome

Early and late results for the endpoints of death, myocardial infarction, and strokehard clinical

Simultaneous carotid endarterectomy and coronary artery bypass grafting is a feasible surgical strategy with acceptable perioperative risks for patients with severe concomitant coronary and carotid artery disease.

Cite This Study

N. Evagelopoulos (2000) studied this question.

synapsesocial.com/papers/6a70ab34ac440176ef295494 https://doi.org/10.1016/s0967-2109(99)00077-0

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Implication

Acceptable perioperative risks support combined CEA-CABG feasibility in selected patients; leaves open randomized comparison to staged approaches.

Simultaneous carotid endarterectomy and coronary artery bypass grafting in 313 patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Simultaneous carotid endarterectomy and coronary artery bypass grafting in 313 patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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