Jahangiri M, Rees G M, Edmondson S J, Lumley J, Uppal R
Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London.
Heart. 1997 Feb;77(2):164-7. doi: 10.1136/hrt.77.2.164.
To assess the early results of combined coronary artery bypass graft surgery and carotid endarterectomy.
Retrospective and ongoing analysis of patients who underwent combined coronary artery bypass graft surgery and carotid endarterectomy.
Cardiothoracic unit in a London teaching hospital.
From June 1987 to March 1995, 64 patients were identified. They were patients who were scheduled to have coronary artery bypass graft surgery or required urgent coronary revascularisation and who were found to have significant coexistent carotid disease. (Unilateral carotid stenosis > 70%, bilateral carotid stenosis > 50%, or unilateral carotid stenosis > 50% with contralateral occlusion.)
Both procedures were performed during one anaesthesia: the carotid endarterectomy was performed first without cardiopulmonary bypass. After completion of carotid endarterectomy, coronary artery bypass graft surgery was performed.
The incidence of stroke, transient ischaemic attack, and myocardial infarction in the early postoperative period was analysed.
Myocardial revascularisation was successful in all 64 patients. There were no perioperative infarcts. In three patients (4.7%) a new neurological deficit developed postoperatively: two recovered fully before hospital discharge.
Combined coronary artery bypass graft surgery and carotid endarterectomy were performed safely and with good results.
评估冠状动脉搭桥术与颈动脉内膜切除术联合手术的早期疗效。
对接受冠状动脉搭桥术与颈动脉内膜切除术联合手术的患者进行回顾性及连续性分析。
伦敦一家教学医院的心胸外科病房。
1987年6月至1995年3月期间，共确定了64例患者。这些患者计划接受冠状动脉搭桥术或需要紧急冠状动脉血运重建，且被发现存在严重的并存颈动脉疾病。（单侧颈动脉狭窄>70%，双侧颈动脉狭窄>50%，或单侧颈动脉狭窄>50%且对侧闭塞。）
两种手术均在一次麻醉下进行：先在不进行体外循环的情况下进行颈动脉内膜切除术。颈动脉内膜切除术后，进行冠状动脉搭桥术。
分析术后早期中风、短暂性脑缺血发作和心肌梗死的发生率。
64例患者的心肌血运重建均成功。围手术期无梗死发生。3例患者（4.7%）术后出现新的神经功能缺损：2例在出院前完全恢复。
冠状动脉搭桥术与颈动脉内膜切除术联合手术实施安全，效果良好。
