Horst M, Geissler H J, Mehlhorn U, Eichstaedt H C, Südkamp M, Kuhn-Regnier F, Raji R, Dapunt O E, de Vivie E R
Center for Cardiothoracic Surgery, University of Cologne, Germany.
Thorac Cardiovasc Surg. 1999 Oct;47(5):328-32. doi: 10.1055/s-2007-1013167.
A significant number of patients with coronary artery disease is diagnosed with additional carotid artery disease. This subset of patients has been identified as a high-risk group for cardiac and cerebral complications following surgical intervention.
In a retrospective analysis we investigated the perioperative outcome of combined single-stage carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) in 63 patients operated between January 1989 and August 1998. In all of these patients, CEA was performed prior to CABG and before initiation of cardiopulmonary bypass.
Perioperative mortality rate was 7.9% (5/63) for simultaneous CEA and CABG and was due to cardiac complications in all patients. Postoperative unilateral neurological symptoms were diagnosed in 1 patient (1.7%) and were completely reversible. No neurologic events suggestive for permanent cerebral damage were observed during the 30 d postoperative period.
In our study combined single-stage CEA and CABG was associated with low cerebral morbidity and patient outcome was mainly determined by cardiac complications. In this subset of patients, simultaneous CEA and CABG appears to be a safe method.
大量冠心病患者被诊断出合并有颈动脉疾病。这部分患者已被确定为手术干预后发生心脏和脑部并发症的高危人群。
在一项回顾性分析中，我们调查了1989年1月至1998年8月期间接受手术的63例患者同期进行单阶段颈动脉内膜切除术（CEA）和冠状动脉搭桥术（CABG）的围手术期结果。在所有这些患者中，CEA在CABG之前且在体外循环开始之前进行。
同期CEA和CABG的围手术期死亡率为7.9%（5/63），所有患者均死于心脏并发症。1例患者（1.7%）术后出现单侧神经症状，且完全可逆。术后30天内未观察到提示永久性脑损伤的神经事件。
在我们的研究中，同期单阶段CEA和CABG的脑发病率较低，患者预后主要由心脏并发症决定。在这部分患者中，同期CEA和CABG似乎是一种安全的方法。
