Staged and Simultaneous Approaches in the Surgical Treatment of Multisystem Disorders of the Carotid and Coronary Bloodflow

Abstract

Aim of study. A comparative analysis of the early outcomes of simultaneous and staged methods of revascularization in patients with a combined coronary and carotid artery stenosis.Materials and methods. The study included 45 patients with combined carotid and coronary artery stenosis, operated at the Republican Research Centre of Emergency Medicine in 2014-2018. Patients were divided into two groups: “simultaneous”, 20 patients (simultaneous interventions on the carotid and coronary arteries were performed) and “staged”, 25 patients (carotid and coronary artery stenoses were operated in a staged manner). In all cases, surgical intervention was performed on the beating heart.Results. According to the results of work in the postoperative period, the incidence of neurological complications in the group of staged interventions and in the group of simultaneous interventions was 4.0% vs 5.0%, respectively. In the group of staged interventions, no deaths were observed, whereas in the group of simultaneous interventions, one lethal outcome was observed (5%) associated with pulmonary complications.Conclusion. According to the results of the work, the simultaneous and staged approaches in the treatment of combined lesions of the carotid and coronary arteries did not differ statistically significantly regarding to cerebral and cardiovascular outcomes.

Keywords

• carotid endarterectomy
• coronary artery bypass grafting
• coronary artery disease
• stenosis of carotid arteries