CASE REPORTS  VASCULAR SECTION 

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

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

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.