Abstract
The management of concomitant coronary and carotid disease is controversial. We report
our experience of simultaneous coronary artery bypass surgery and carotid artery endarterectomy
on 70 consecutive patients (34 males and 36 females) with a mean age of 68 years.
The oldest patient was 91 years old. The average percent of carotid artery stenosis
was 86% (range 60%–99%). The average number of grafts per patient was 3.35 (range
1–6). Two patients experienced postoperative strokes (2.86%), 1 had a perioperative
infarct (1.42%), and 4 died in the hospital (5.7%). The simultaneous approach offers
the advantage of shorter hospital stays, decreased anesthesia exposure, and significant
cost savings. The causes of death include stroke, renal failure, and bowel infarction.
This review indicates the simultaneous approach has a higher incidence of adverse
outcomes compared with elective carotid endarterectomy or elective coronary artery
bypass surgery. These patients, however, are at significantly higher risk due to their
poor medical conditions, extensive atheromatous disease, and often emergent medical
condition.
