Çalişan Kalpte Koroner Baypas İle Eş Zamanli ve Aşamali Karotis Endarterektominin Erken Dönem Sonuçlari

In patients with concomitant carotid and coronary artery disease, no consensus has been established in terms of the surgical approach. Though succesful results have been reported for combined surgery, studies that showed an increase in mortality and morbidity have also been reported. In this study, we aimed to compare the results of cases with concomitant carotis endarterectomy and coronary artery bypass with cases who had staged carotis endarterectomy with coronary bypass surgery in beating heart. In our clinic, a total of 45 cases (15 woman, 30 male) that had combined carotis endarterectomy with coronary artery bypass and staged carotis endarterectomy with coronary bypass surgery in beating heart between 2000-2006 were retrospectively evaluated. The cases were examined in two groups: group 1 had combined carotis endarderectomy and coronary artery bypass and group 2 had staged carotid endarderectomy and coronary bypass surgery in beating heart. There were no significant differences between two groups in terms of preoperative demographic charactheristics. The mean age of the cases in group 1 and group 2 was 65.7±4.7and 66.1±4.3, respectively. In group 1 and 2 the female to male ratios were 7/15 and 8/15, respectively. In group 1 in one case died due to low cardiac output. There was no mortality in group 2. In group 1, one case had temporary stroke. In group 2, one case had a transient ischemic attack. No significant difference was found between the groups in terms of mortality and morbidity. Since results of cases with concomitant carotid endarterectomy and coronary artery bypass and cases who had staged carotis endarterectomy with coronary bypass surgery in beating heart are similar, we assume that combined surgery may be safely used in cases with critical carotid artery stenosis with coronary artery disease.