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ISSN 2448-5640 (Print)
Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2016, Number 4

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Cir Card Mex 2016; 1 (4)

Revascularización miocárdica y endarterectomía carotídea: resultados del abordaje simultaneo

Orozco-Hernández EJ, Herrera-Llamas RM, Ramirez-Valdivia LA, Prior-Gonzalez OA, Torres-Herrera JA

Language: Spanish
References: 14
Page: 124-128
PDF size: 243.01 Kb.


ABSTRACT

Objective. Evaluate our experience with simultaneous myocardial revascularization and carotid endarterectomy in the approach for patients with severe carotid and coronary artery disease, in terms of perioperative mortality and morbility.
Methods. Retrospective study of patients underwent to simultaneous myocardial revascularization and carotid endarterectomy , from November 2012 to November 2015.
Results. 13 patients. Average patient age was 70 years, 10 (76%) were male. 100% with functional class deterioration and/or angina. 12 (92%) of the patients with severe carotid didn´t have cerebrovascular symptoms. The left main coronary artery disease was critical in 10, and three vessels disease in 12. Carotid stenosis was unilateral in 11 and bilateral in 2. 3 patients suffer from valvular heart disease . General anesthesia , cardiopulmonary bypass and carotid shunting was used in all the cases. Patch angioplasty in 12 patients. In the patients without valvular surgery, mortality was 7.6% , from postcardiotomy ventricular failure, there were zero strokes and zero myocardial infarction. In patients with valvular surgery, 1 patient died from a ipsilateral stroke, in this group were 2 strokes and 1 myocardial infarction postoperative.
Conclusions. Simultaneous approach is a viable strategy for patients with severe coronary and carotid disease. The ideal procedure is controversial, and we require randomized studies to define the real rol of the available techniques.


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