Key result
Synchronous carotid endarterectomy and coronary artery bypass grafting resulted in a 1.3% case fatality rate compared to 1.7% for staged procedures, with fewer perioperative complications.
Why the study?
The immediate results of staged versus synchronous carotid endarterectomy and coronary artery bypass grafting in patients with carotid artery stenosis and coronary artery disease required assessment.
Does synchronous CE and CABG improve postoperative complications and case fatality compared to staged CE and CABG in patients with combined carotid artery stenosis and coronary artery disease?
Cohort (n=175)
No
Does synchronous CE and CABG improve postoperative complications and case fatality compared to staged CE and CABG in patients with combined carotid artery stenosis and coronary artery disease?
Absolute Event Rate: 1.3% vs 1.7%
Synchronous carotid endarterectomy and CABG on the working heart is associated with lower perioperative complications and shorter postoperative recovery compared to a staged approach.
May support synchronous CEA+CABG in combined disease; leaves open need for randomized confirmation before practice change.
Aim. Assessment of the immediate results of staged versus synchronous carotid endarterectomy and coronary artery bypass grafting methods in patients with carotid artery stenosis and coronary artery disease.Patients. The results of synchronous and staged surgeries conducted among 175 patients in the Republican research center of emergency medicine from 2014 to 2021 were analyzed. Patients were divided intotwo groups: Group 1 – 75 patients who underwent carotid endarterectomy (CE) and aorto-coronary bypass grafting (CABG) synchronously on the working heart; Group 2 – 100 patients in whom CE and CABGwere performed in stages.Results. Synchronous and staged interventions in combined carotid and coronary stenosis are accompanied by good results and demonstrated low rates of postoperative complications and case fatality (1.3% inthe synchronous group and 1.7% in the staged group).Conclusion. The synchronous approach is accompanied by a lower frequency of perioperative complications, a shorter postoperative period and can be a method of choosing surgical treatment for carotid arterystenosis and coronary artery disease.
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Mashrapov et al. (2023) conducted a cohort in carotid artery stenosis and coronary artery disease (n=175). Synchronous carotid endarterectomy and coronary artery bypass grafting vs. Staged carotid endarterectomy and coronary artery bypass grafting was evaluated on case fatality. Synchronous carotid endarterectomy and coronary artery bypass grafting resulted in a 1.3% case fatality rate compared to 1.7% for staged procedures, with fewer perioperative complications.
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