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The Journal of Cardiovascular Surgery 2009 October;50(5):683-86

language: English

Effective surgical treatment of the carotid sinus sindrome

Toorop R. J. 1, Scheltinga M. R. M. 1, Bender M. H. M. 1, Charbon J. A. 1, Huige M. C. 2, Moll F. L. 3, Bruijninckx C. M. A. 4

1 Department of Surgery, Máxima Medical Centre , Veldhoven, The Netherlands
2 Department of Cardiology, Máxima Medical Centre, Veldhoven, The Netherlands
3 Department of Vascular Surgery, University Hospital, Utrecht, The Netherlands
4 Department of Surgery, Haga Hospital, The Hague, The Netherlands


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Elderly patients frequently suffer from dizziness and syncope; however, an underlying disease may not always be identified. Three patients aged 69, 71 and 56, respectively, experienced spells of dizziness and syncope. Massage of the carotid sinus demonstrated the presence of a carotid sinus syndrome (CSS), an abnormal baroreflex response of the carotid sinus that leads to asystole and extreme hypotension. Conventional treatment is generally by insertion of a pacemaker. These patients, however, were referred to the vascular surgery department of our hospital for removal of adventitial layers of proximal portions of the internal carotid artery. Recovery was uneventful; all three are now free of symptoms. CSS should be considered in the differential diagnosis of dizziness and syncope. Surgical denervation of the carotid artery is a valid treatment option, especially in the vasodepressive or mixed type of CSS.

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