Carotid Surgery In Patients With Ischemic Heart Disease

Abstract

In cases with combined carotid and coronary pathology the optimal approach for surgery remain debatable. The aim of this retrospective study was to analyze the results of carotid artery revascularization in patients with combined carotid pathology and ischemic heart disease, and to determine the applying therapeutical approach in these patients. 527 surgical interventions on the carotid artery, in 513 patients had been operated for 9 years (from January 2000 to December 2009) at the “Department of Vascular Surgery and Angiology” of “St. Ekaterina” University Hospital – Sofia. The patients were separated in two groups according to presence or absence of concomitant ischemic heart disease. The frequency of the risk factors in both groups and their influence of the postoperative results were determined. In both groups hypertension was the most powerful risk factor for stroke, followed by smoking, dyslipidemia, peripheral vascular diseases and diabetes. Commonly for both groups neurological complications were found in 2,14% of the patients and death rates was 0,78%. There are no integrated statement regarding to advantages of combined surgical treatment of carotid and coronary pathology compare with staged surgery – CEA or cardiosurgery.