Coronary artery bypass and carotid endarterectomy with mild hypothermia

Abstract

The approach to treatment in patients with both coronary artery disease and major carotid disease is controversial. We analyzed our results of concomitant coronary artery bypass and carotid endarterectomy. Twenty-three patients aged 58 years or older underwent elective concomitant coronary artery bypass and carotid endarterectomy with mild hypothermia (32°C). Demographic characteristics and preoperative risk factors were recorded prospectively. Data were collected during a mean follow-up of 22 ± 9 months. The mean age of the patients was 71 ± 7 years. Twenty-one patients were in New York Heart Association class I to II, and 2 were in class III. Early mortality was 8.6%. There was no early postoperative stroke. Mean intensive care unit stay was 64.5 ± 30.5 h. One (4.3%) patient had a stroke one year later. One- and 2-year survival rates were estimated to be 86.9% and 73.9%, respectively. Although concomitant coronary and carotid artery surgery remains controversial, cooling to 32°C provided good results in this challenging group of patients managed by one team.