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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.