Szabolcs Z, Bodor E, Széphelyi K, Hüttl K, Gyöngy T, Mogán I
Er- és Szívsebészeti Klinika, Semmelweis Orvostudományi Egyetem, Budapest.
Orv Hetil. 1993 Apr 18;134(16):849-52.
The incidence of cerebral complications following extracorporal cardiac operations is reported to be approximately 2%. One of the possible reasons behind these complications is the presence of significant carotid stenosis as coexistent disease to the cardiac illness requiring surgery. Because of the common etiology carotid stenosis coexists mainly with a coronary artery disease. The authors make known their own screening methods based on the correct exploration of medical history and on the proper physical examinations. Coexistent significant carotid stenosis was revealed in 3.6% of 1056 patients who underwent coronary surgery within the period of 41 months. In all of these cases prophylactic carotid endarterectomy was performed. In twenty cases within this group the carotid reconstructions were performed simultaneously with myocardium revascularization. Staged endprocedures were performed in the other 18 cases. There was no surgical mortality and only one patient suffered major stroke. The authors emphasize the importance of carotid screening among patients awaiting coronary surgery especially in patients who previously sustained cerebral ischemic attacks, the presence of carotid bruits or any other known localization of obliterate arterial disease and finally in all patients over 60 years of age.
据报道，体外心脏手术后脑部并发症的发生率约为2%。这些并发症背后的一个可能原因是存在严重的颈动脉狭窄，这是需要手术治疗的心脏疾病的并存疾病。由于病因相同，颈动脉狭窄主要与冠状动脉疾病并存。作者介绍了他们基于正确询问病史和适当体格检查的筛查方法。在41个月内接受冠状动脉手术的1056例患者中，3.6%发现存在并存的严重颈动脉狭窄。在所有这些病例中，均进行了预防性颈动脉内膜切除术。该组中有20例患者在进行心肌血运重建的同时进行了颈动脉重建。另外18例患者进行了分期手术。没有手术死亡病例，只有1例患者发生了严重中风。作者强调了在等待冠状动脉手术的患者中进行颈动脉筛查的重要性，特别是在既往有脑缺血发作、存在颈动脉杂音或任何其他已知的闭塞性动脉疾病定位的患者中，以及最终在所有60岁以上的患者中。
