Comparison of early outcomes with three approaches for combined coronary revascularization and carotid endarterectomy
Rev. bras. cir. cardiovasc
; Rev. bras. cir. cardiovasc;31(5): 365-370, Sept.-Oct. 2016. tab
Article
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| ID: biblio-829750
Biblioteca responsável:
BR1.1
ABSTRACT
Abstract Objective:
This study aims to compare three different surgical approaches for combined coronary and carotid artery stenosis as a single stage procedure and to assess effect of operative strategy on mortality and neurological complications.Methods:
This retrospective study involves 136 patients who had synchronous coronary artery revascularization and carotid endarterectomy in our institution, between January 2002 and December 2012. Patients were divided into 3 groups according to the surgical technique used. Group I included 70 patients who had carotid endarterectomy, followed by coronary revascularization with on-pump technique, group II included 29 patients who had carotid endarterectomy, followed by coronary revascularization with off-pump technique, group III included 37 patients who had coronary revascularization with on-pump technique followed by carotid endarterectomy under aortic cross-clamp and systemic hypothermia (22-27ºC). Postoperative outcomes were evaluated.Results:
Overall early mortality and stroke rate was 5.1% for both. There were 3 (4.3%) deaths in group I, 2 (6.9%) deaths in group II and 2 (5.4%) deaths in group III. Stroke was observed in 5 (7.1%) patients in group I and 2 (6.9%) in group II. Stroke was not observed in group III. No statistically significant difference was observed for mortality and stroke rates among the groups.Conclusion:
We identified no significant difference in mortality or neurologic complications among three approaches for synchronous surgery for coronary and carotid disease. Therefore it is impossible to conclude that a single principle might be adapted into standard practice. Patient specific risk factors and clinical conditions might be important in determining the surgical tecnnique.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Doença da Artéria Coronariana
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Ponte de Artéria Coronária
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Endarterectomia das Carótidas
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Estenose das Carótidas
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Acidente Vascular Cerebral
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
CARDIOLOGIA
/
CIRURGIA GERAL
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Turquia
País de publicação:
Brasil