[The influence of carotid artery stenosis on neurological outcomes in patients undergoing off-pump coronary artery bypass grafting].

OBJECTIVE

To investigate the influence of carotid artery stenosis on the incidence of neurological complication in patients undergoing off-pump coronary artery bypass grafting.

METHODS

We prospectively analyzed 176 consecutive patients ≥ 60 years old undergoing selective off-pump coronary artery bypass grafting (from June 2010 to July 2011). Carotid duplex ultrasound screening was used to determine the presence and severity of carotid artery before surgery. Neurological complications 7 days after surgery were compared between the patients with (≥ 75%) and without severe carotid artery stenosis (< 70%). Multivariate analysis was used to determine the predictor of severe carotid artery disease.

RESULTS

Sixteen patients (9.1%) were found to have severe carotid artery stenosis before surgery. Thirty-seven patients (20.8%) had single or multiple neurological complications: 1 (0.6%) had stroke; 12 (6.7%) had hypoxic-metabolic encephalopathy; 21 (11.8%) had cognitive dysfunction; 3 (1.7%) had depression. When compared with the counterparts, patients with severe carotid artery stenosis had a higher rate of neurological complications (43.8% vs 18.8%; P = 0.044). In multivariate analysis, significant predictive factor for severe carotid artery stenosis was prior stroke (OR: 4.04; 95%CI 1.22 - 13.37).

CONCLUSION

Severe carotid artery stenosis alone is a risk factor for neurological complication after off-pump coronary artery bypass grafting and prior stroke is a predictor for sever carotid artery disease.