Simultaneous coronary artery bypass and carotid operations

Coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA) were performed in 43 patients either at the same or in different operations. In all, 48 CEAs were performed. Simultaneous operations were performed 32 times (17 CEAs before cardiopulmonary bypass [CPB], 15 CEAs after the beginning of CPB). Thirteen CEAs were performed at different operations prior to CABG and 3 CEAs after CABG. One patient whose left carotid artery was operated on during CPB suffered from left-sided hemiparesis one day postoperatively. There were no other hemipareses or deaths related to the operation. The control group consisted of 49 patients in whom CABG was performed. The number of risk factors (family predilection, smoking, diabetes, hyperlipidemia, and acute myocardial infarction) was significantly higher in the study group (2.1, SD 1.0 versus 1.4, SD 1.0). The number of significant left main coronary artery stenoses was double in the study group compared with the control group, but the difference was not statistically significant. Also there were no statistical differences in frequencies of one-, two- or three-vessel disease. There were no statistical differences between the groups in New York Heart Association (NYHA) classification. This study shows that CEA can be safely done simultaneously with CABG.