Hospital and midterms outcomes after simultaneous carotid endarterectomy and coronary artery bypass grafting

INTRODUCTION: Optimal surgical approach of patients undergoing coronary artery bypass graft surgery with significant carotid disease remains controversial. The accumulation of clinical data. especially with the evaluation of long-term outcomes is relevant. The study aim was to examine the effectiveness and safety of simultaneous carotid endarterectomy and coronary artery bypass grafting. MATERIAL AND METHODS: Retrospective study. The group of 114 patients with indications for carotid endarterectomy and coronary artery bypass grafting who underwent simultaneous surgery from January 2010 to December 2019, was considered. The hospital and mid-term outcomes was analyzed. RESULTS: Hospital mortality was 2/114 (1.8%); the cause of death in both cases was cardiac. Non-fatal myocardial infarction occurred in 1/114 (0.9%). Perioperative cerebrovascular events developed in 2/114 (1.8%): in one case it was an ipsilateral stroke, in the other it was a transient ischemic attack. 112 patients were discharged from the clinic. At the time of the mid-term assessment, complete data were available in 81/112 (72.3%). Median follow-up is 46 months (12 to 120). In the mid-term period, all-cause mortality was 11/81 (13.6%), angina recurrence developed in 14/81 (17.3%) patients, of which 6 underwent percutaneous coronary interventions. Neurological events developed in 2/81 (2.5%): one had a transient ischemic attack, the other had a fatal hemorrhagic stroke. An important fact was the absence of cases of ischemic stroke. Actuarial survival at 3, 5, and 7 years was 93%, 88%, and 81%, respectively. CONCLUSION: Simultaneous surgery in patients with carotid disease and coronary artery disease can be performed with an acceptable hospital outcomes and good mid-term incidence angina recurrence and cerebrovascular events.