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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2012 June;19(2):97-101
Twenty years of experience with combined carotid endarterectomy and coronary artery bypass grafting
Borioni R. 1, Garofalo M. 1, Nardi P. 2, Weltert L. 1, Scaffa R. 1, De Paulis R. 1, Chiariello L. 2
1 Department of Cardiovascular Sciences, European Hospital, Rome, Italy;
2 Department of Cardiac Surgery, Tor Vergata University, Rome, Italy
Aim. This series reports a 20-year single-center experience in combined carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG).
Methods. Data on 411 consecutive patients (322 males, 89 females, mean age 69.5 years, range 49-88) undergoing synchronous CEA and CABG over a period of twenty years (1990-2009) were collected to review the cumulative morbidity and mortality rate. Moreover, The results of 261 patients undergoing combined CEA/CABG in the period 1999-2009 were compared with the 150 patients who underwent CEA/CABG during the first ten years of experience.
Results. Out of 7617 consecutive CABG, 411 patients (5.3%), underwent combined CEA and CABG procedures. Neurological complications occurred in 5 patients (1.2%). The 30-days mortality was 7% (N.=29). The surgical risk decreased over the time, accounting for a 30-days mortality rate of 4.2% in the period 1999-2009 versus 12% in the period 1990-1998 (P=0.0057).
Conclusion. Combined CEA and CABG can be performed with acceptable results. However, the value to add carotid procedures to CABG is still questionable, and further studies have to provide conclusive evidences.