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CHIRURGIA

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Chirurgia 2011 February;24(1):43-6

language: English

Combined coronary artery bypass grafting with bilateral carotid endarterectomy

Gurkan S., Huseyin S., Ege T.

Trakya University Faculty of Medicine, Department of Cardiovascular Surgery, Edirne, Turkey


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The treatment of patients with both coronary artery disease and major carotid disease is still controversial. This article reports two cases. The first concerns a 67-year-old man who was admitted for CABG due to unstable angina and left main coronary artery disease (LMCA). A Duplex scan revealed revealed >90% stenosis of the right internal carotid artery (ICA), >80% stenosis of the left internal carotid artery. The second concerns a 60-year-old woman with diabetes and hypertension who was admitted for CABG due to unstable angina. A Duplex scan which is confirmed with magnetic resonance angiography revealed >90% stenosis of the right ICA and >70% stenosis of the left ICA. Both two patients were offered bilateral CEA at the same time as their coronary revascularization. The exposure of both common carotid arteries and their bifurcations were performed through a vertical servical incision anterior to the sternocleidomastoid muscle. Standart CEA was routinely done on both sides. The neck incisions were closed with suction drains after the completion of the coronary revascularization.No permanent or transient neurological events were observed in the early postoperative period and at one month control. In conclusion, patients presenting with significant coronary artery disease associated with symptomatic or asymptomatic bilateral carotid artery occlusive disease should be considered for combined procedure.

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