You are here

Home » Content

Koroner ve Karotis Arter Hastalığında Kombine Cerrahi Tedavi

Combined Surgical Treatment of Coronary and Carotid Artery Disease

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2012
DOI: 
http://dx.doi.org/10.5505/abantmedj.2012.18291

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Background: Occurrence of myocardial infarction after carotid endarterectomy and cerebrovascular accident after myocardial revascularization procedures are both severe and frequent complications. In this study we aimed to pre-sent 22 patients who underwent combined carotid endarterectomy and coronary surgery procedure. Method: 22 patients who underwent combined carotid endarterectomy and coronary surgery procedure between June 2006 and July 2011 examined retrospectively also with early and mid-term results. Risk factors, mortality and une-ventful survival rates were evaluated. Results: One patient died due to low cardiac output in the early postoperative period. A Minor neurologic event devel-oped in another patient and resolved spontaneously. All patients included this one, discharged an average of 8±2 days postoperatively. In the combine procedure, average carotid clamp time was 25±7,8 min. and aortic cross clamp time was 48±12 min. The average length of stay in intensive care unit was 36±4,5 hours. Average hospital stay was 7,4±1,2 days. 90% of patients were followed clinically. Dur-ing follow up period of 18±12.2 months no patients devel-oped cardiac or neurological problems. Conclusion: In the presence of significant carotid stenosis in patients schedules for coronary bypass surgery, in these patients combined procedure can be applied with success.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Karotis arter endarterektomisi sonrası miyokard enfarktüsü, koroner arter bypass cerrahisi sonrası serebro-vasküler olay son derece ciddi ve sık karşılaşılan komplikas-yonlardır. Bu çalışmada koroner arterlere ve karotis arterine yönelik kombine girişim uygulanan 22 hastayı sunmayı amaçladık. Yöntem: Haziran 2006 ile Temmuz 2011 tarihleri arasında kombine koroner bypass ve karotis endarterektomi uygula-nan 22 olgunun erken ve orta dönem mortalite, morbidite ve olaysız yaşam oranları retrospektif olarak değerlendirildi. Bulgular: Erken postoperatif dönemde 22 olgu içerisinde bir olgu düşük kardiyak debi nedeniyle kaybedildi, bir olgu ise geçici minör nörolojik olay gelişti. Bu olgu ile birlikte tüm olgular postoperatif ortalama 8. günde taburcu edildi. Kom-bine cerrahide karotis arter kross klemp süresi ortalama için 25±7,8 dakika, aortik kross klemp süresi 48±12 dakika olarak gerçekleşti. Diğer tüm olgular yoğun bakımda ortalama 36±4.5 saat ve serviste ortalama 7.4±1.2 gün kaldıktan sonra taburcu edildiler. Olguların 18’i (%90) klinik olarak 230 hasta ayı (ortalama 18±12.2 ay) izlenebildi. Bu süre boyunca hiçbir hastada kardiyak ve nörolojik mortalite ya da morbidite gelişmedi. Sonuç: Koroner bypass planlanan ve anlamlı karotis arter darlığı tespit edilen ancak anstabil anjina pektorisi olan hastalara eş zamanlı karotis arter endarterektomisi başarı ile uygulanabilir.
FULL TEXT (PDF): 
PDF icon arastirmax-koroner-karotis-arter-hastaliginda-kombine-cerrahi-tedavi.pdf
  • 3
107-110
  • Turkish

REFERENCES

References: 

1. Hertzer NR, Loop FD, Taylor PC, Beven EG. Combined myocardial revascularization and carotid endarterec-tomy: Operative and late results in 331 patients. J Thorac Cardiovasc Surg 1983;85:577-89.
2. Öztürk S, Öztürk S. Approach of dyslipidemia; as a cardiovascular risk factor. Abant Med J 2012; 1: 89-93.
3. Jones EL, Craver JM, Michalik RA, Murphy DA, Guyton RA, Bone DK, Hatcher CR, Reichwald NA. Combined carotid and coronary operations: When are they nec-essary? J Thorac Cardiovasc Surg 1984;87:7-16.
4. Faggioli GL, Curl GR, Ricotta JJ. The role of carotid screening before coronary artery bypass. J Vasc Surg 1990;12:724-31.
5. Akins LW, Moncure AC, Daggett WM. Safety and efficiency of concomitant carotid and coronary artery operations. Ann Thorac Surg 1995;60:311-8.
6. Davila-Roman VG, Barzilai B, Wareing TH, Murphy SF, Kouchoukos NT. Intraoperative ultrasonographic evaluation of the ascending aorta in 100 consecutive patients undergoing cardiac surgery. Circulation 1991;84:47-53.
7. Ennix CL Jr, Lawrie GM, Morris GC Jr, Crawford ES, Howell JF, Reardon MJ, Weatherford SC. Improved re-sults of carotid endarterectomy in patients with symptomatic coronary disease: An analysis of 1546consecutive carotid operations. Stroke 1979;10:122-5.
8. Borger MA, Fremes SE, Weisel RD, Cohen G, Rao V, Lindsay TF, Naylor CD. Coronary bypassand carotid endarterectomy: Does a combined approach increase risk? A metaanalysis. Ann Thorac Surg 1999;68:14-20.
9. Ketenci B, Guney MR, Cimen S, Gunay R, Ozay B, Turkoglu R, Ozkul V, Gorur A, Demirtas M. Carotis and coronary artery dısease: is concomıtant operatıon necessary? Turkish J Thorac Cardiovasc Surg 2005;13:6-9
10. Evagelopoulos N, Trenz MT, Beckmann A, Krian A. Simultaneous carotid endarterectomy and coronary artery bypass grafting in 313 patients. Cardiovasc Surg 2000;8:31-40.
11. Khaitan L, Sutter FP, Goldman SM, Chamogeorgakis T, Wertan MA, Priest BP, Whitlark JD. Simultaneous ca-rotid endarterectomy and coronary revascularization. Ann Thorac Surg 2000;69:421-4.
12. Gaudino M, Glieca F, Alessandrini F, Cellini C, Luciani N, Pragliola C, Schiavello R, Possati G. Individualized surgical strategy for the reduction of stroke in pa-tients undergoing CABG. Ann Thorac Surg 1999;67:1246-53.
13. Plestis KA, Ke S, Jiang ZD, Howell JF. Combined carotid endarterectomy and coronary artery bypass: Immedi-ate and long-term results. Ann Vasc Surg 1999;13:84-92.
14. Yapıcı F, Gürer O, Enç Y, Çınar B, Güney MR, Yapıcı N, Bilgen F, Özler A. Combıned surgery for coronary and carotid artery disease: management and results. Turk-ish J Thorac Cardiovasc Surg 2002;10:229-234.

Thank you for copying data from http://www.arastirmax.com