An alternative method of maintaining carotid perfusion during combined carotid endarterectomy and off-pump coronary artery bypass grafting involves insertion of a cannula in the ascending aorta after a median sternotomy. This cannula is connected to a perfusion cannula, the distal end of which is inserted into the carotid artery beyond the carotid arteriotomy. This technique of aortico-carotid shunting and carotid perfusion was utilized in nine patients who underwent successful combined carotid endarterectomy and off-pump coronary artery bypass grafting.
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References
1.
FaggioliGLCurlGRRicottaJJ. The role of carotid screening before coronary artery bypass. J Vasc Surg1990;12:724–31.
2.
D'AgostinoRSSvenssonLGNeumannDJBalkhyHHWilliamsonWAShahianDM. Screening carotid ultrasonography and risk factors for stroke in coronary artery surgery patients. Ann Thorac Surg1996;62:1714–23.
3.
Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA1995;273:1421–8.
4.
BraunSLBarankayAMazzitelliD. Plasma troponin T and troponin I after minimally invasive coronary bypass surgery. Clin Chem2000;46:279–81.
5.
BrodkinIAMurkinJM. Protection of the brain during cardiac surgery. In: HensleyFAMartinDE, editors. A Practical Approach to Cardiac Anesthesia. 2nd ed.Boston: Little, Brown and Company, 1995;581–600.
6.
North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med1991;325:445–53.
7.
GottJPThouraniVHWrightCEBrownWM3rdAdamsABSkardasisGM. Risk neutralization in cardiac operations: Detection and treatment of associated carotid disease. Ann Thorac Surg1999;68:850–7.
