Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Cardiovascular Surgery (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382016000500365 |
Resumo: | Abstract Objective: This study aims to compare three different surgical approaches for combined coronary and carotid artery stenosis as a single stage procedure and to assess effect of operative strategy on mortality and neurological complications. Methods: This retrospective study involves 136 patients who had synchronous coronary artery revascularization and carotid endarterectomy in our institution, between January 2002 and December 2012. Patients were divided into 3 groups according to the surgical technique used. Group I included 70 patients who had carotid endarterectomy, followed by coronary revascularization with on-pump technique, group II included 29 patients who had carotid endarterectomy, followed by coronary revascularization with off-pump technique, group III included 37 patients who had coronary revascularization with on-pump technique followed by carotid endarterectomy under aortic cross-clamp and systemic hypothermia (22-27ºC). Postoperative outcomes were evaluated. Results: Overall early mortality and stroke rate was 5.1% for both. There were 3 (4.3%) deaths in group I, 2 (6.9%) deaths in group II and 2 (5.4%) deaths in group III. Stroke was observed in 5 (7.1%) patients in group I and 2 (6.9%) in group II. Stroke was not observed in group III. No statistically significant difference was observed for mortality and stroke rates among the groups. Conclusion: We identified no significant difference in mortality or neurologic complications among three approaches for synchronous surgery for coronary and carotid disease. Therefore it is impossible to conclude that a single principle might be adapted into standard practice. Patient specific risk factors and clinical conditions might be important in determining the surgical tecnnique. |
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Brazilian Journal of Cardiovascular Surgery (Online) |
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Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid EndarterectomyCoronary Artery BypassEndarterectomy, CarotidCarotid Artery DiseasesAbstract Objective: This study aims to compare three different surgical approaches for combined coronary and carotid artery stenosis as a single stage procedure and to assess effect of operative strategy on mortality and neurological complications. Methods: This retrospective study involves 136 patients who had synchronous coronary artery revascularization and carotid endarterectomy in our institution, between January 2002 and December 2012. Patients were divided into 3 groups according to the surgical technique used. Group I included 70 patients who had carotid endarterectomy, followed by coronary revascularization with on-pump technique, group II included 29 patients who had carotid endarterectomy, followed by coronary revascularization with off-pump technique, group III included 37 patients who had coronary revascularization with on-pump technique followed by carotid endarterectomy under aortic cross-clamp and systemic hypothermia (22-27ºC). Postoperative outcomes were evaluated. Results: Overall early mortality and stroke rate was 5.1% for both. There were 3 (4.3%) deaths in group I, 2 (6.9%) deaths in group II and 2 (5.4%) deaths in group III. Stroke was observed in 5 (7.1%) patients in group I and 2 (6.9%) in group II. Stroke was not observed in group III. No statistically significant difference was observed for mortality and stroke rates among the groups. Conclusion: We identified no significant difference in mortality or neurologic complications among three approaches for synchronous surgery for coronary and carotid disease. Therefore it is impossible to conclude that a single principle might be adapted into standard practice. Patient specific risk factors and clinical conditions might be important in determining the surgical tecnnique.Sociedade Brasileira de Cirurgia Cardiovascular2016-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382016000500365Brazilian Journal of Cardiovascular Surgery v.31 n.5 2016reponame:Brazilian Journal of Cardiovascular Surgery (Online)instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)instacron:SBCCV10.5935/1678-9741.20160076info:eu-repo/semantics/openAccessDönmez,Arzu AntalAdademir,TaylanSacli,HakanKoksal,CengizAlp,Meteeng2016-12-07T00:00:00Zoai:scielo:S0102-76382016000500365Revistahttp://www.rbccv.org.br/https://old.scielo.br/oai/scielo-oai.php||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br1678-97410102-7638opendoar:2016-12-07T00:00Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)false |
dc.title.none.fl_str_mv |
Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy |
title |
Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy |
spellingShingle |
Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy Dönmez,Arzu Antal Coronary Artery Bypass Endarterectomy, Carotid Carotid Artery Diseases |
title_short |
Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy |
title_full |
Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy |
title_fullStr |
Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy |
title_full_unstemmed |
Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy |
title_sort |
Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy |
author |
Dönmez,Arzu Antal |
author_facet |
Dönmez,Arzu Antal Adademir,Taylan Sacli,Hakan Koksal,Cengiz Alp,Mete |
author_role |
author |
author2 |
Adademir,Taylan Sacli,Hakan Koksal,Cengiz Alp,Mete |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Dönmez,Arzu Antal Adademir,Taylan Sacli,Hakan Koksal,Cengiz Alp,Mete |
dc.subject.por.fl_str_mv |
Coronary Artery Bypass Endarterectomy, Carotid Carotid Artery Diseases |
topic |
Coronary Artery Bypass Endarterectomy, Carotid Carotid Artery Diseases |
description |
Abstract Objective: This study aims to compare three different surgical approaches for combined coronary and carotid artery stenosis as a single stage procedure and to assess effect of operative strategy on mortality and neurological complications. Methods: This retrospective study involves 136 patients who had synchronous coronary artery revascularization and carotid endarterectomy in our institution, between January 2002 and December 2012. Patients were divided into 3 groups according to the surgical technique used. Group I included 70 patients who had carotid endarterectomy, followed by coronary revascularization with on-pump technique, group II included 29 patients who had carotid endarterectomy, followed by coronary revascularization with off-pump technique, group III included 37 patients who had coronary revascularization with on-pump technique followed by carotid endarterectomy under aortic cross-clamp and systemic hypothermia (22-27ºC). Postoperative outcomes were evaluated. Results: Overall early mortality and stroke rate was 5.1% for both. There were 3 (4.3%) deaths in group I, 2 (6.9%) deaths in group II and 2 (5.4%) deaths in group III. Stroke was observed in 5 (7.1%) patients in group I and 2 (6.9%) in group II. Stroke was not observed in group III. No statistically significant difference was observed for mortality and stroke rates among the groups. Conclusion: We identified no significant difference in mortality or neurologic complications among three approaches for synchronous surgery for coronary and carotid disease. Therefore it is impossible to conclude that a single principle might be adapted into standard practice. Patient specific risk factors and clinical conditions might be important in determining the surgical tecnnique. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382016000500365 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382016000500365 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/1678-9741.20160076 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cirurgia Cardiovascular |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cirurgia Cardiovascular |
dc.source.none.fl_str_mv |
Brazilian Journal of Cardiovascular Surgery v.31 n.5 2016 reponame:Brazilian Journal of Cardiovascular Surgery (Online) instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) instacron:SBCCV |
instname_str |
Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) |
instacron_str |
SBCCV |
institution |
SBCCV |
reponame_str |
Brazilian Journal of Cardiovascular Surgery (Online) |
collection |
Brazilian Journal of Cardiovascular Surgery (Online) |
repository.name.fl_str_mv |
Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) |
repository.mail.fl_str_mv |
||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br |
_version_ |
1752126599428308992 |