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Fırat Tıp Dergisi
2012, Cilt 17, Sayı 4, Sayfa(lar) 196-200
[ Turkish ] [ Tam Metin ] [ PDF ]
The Incidence of Neurologic Event in Patients with Asymptomatic Carotid Artery Stenosis after Priority Coronary Artery Bypass Graft Operation
Arif GÜCÜ1, Derih AY1, Faruk TOKTAŞ1, Gündüz YÜMÜN1, Ayhan UYSAL2, Mehmet Tuğrul GÖNCÜ1
1Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Bursa, Türkiye
2Fırat Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Elazığ, Türkiye

Objective: The coexistence of carotid artery and coronary artery disease is one of the major pathologies for cardiovascular surgeons. In patients undergoing Coronary Artery Bypass Graft (CABG) with carotid artery stenosis, treatment strategies have still a lot of uncertainties. Carotid and coronary artery surgical treatment can be done as a single procedure, or one of them can be done first. In this retrospective study, we evaluated the incidence of cerebrovascular accident in the asymptomatic carotid artery stenosis cases who underwent coronary artery surgery.

Materials and Methods: Between 2006 and 2010, 258 patients were admitted for coronary bypass surgery in Bursa State Hospital. Seventeen patients were asymptomatic moderate carotid stenosis cases, 8 patients were asymptomatic critical carotid stenosis cases. Preference CABG was applied to the all patients. Our surgical strategy included to have modarete hypothermia, high perfusion presure during the cardiopulmonary bypass (CPB), to try to be keep CPB and X-clamp time shortly and to avoid hypotension in the perioperative or postoperative period.

Results: There was no mortality and no major stroke in the early postoperative period. In two patients, transient ischemic accident was observed in the early postoperative period and recovered without any sequel. Statistically no significant difference was found between the two groups for the development of transient ischemic accident (p=0,56).

Conclusion: In patients with asymptomatic carotis stenosis, if proper surgical strategy is applied, CABG can be performed with acceptable mortality and morbidity.


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