Management of coexistent carotid and coronary artery occlusive atherosclerosis
Carotid Artery Diseases
Coexistent carotid and coronary artery occlusive disease was managed in a consecutive series of 92 patients over a 7-year period. Simultaneous carotid artery reconstruction and myocardial revascularization was carried out in 44 patients with only two perioperative deaths (neither directly cardiac related) and one transient neurologic deficit. The operative sequence of carotid repair before myocardial revascularization was elected in a group of 35 patients with seven deaths, a mortality of 20%. Three patients died of myocardial infarctions after carotid artery reconstruction and before coronary surgery could be carried out. Three others died of cardiac-related causes and one of a stroke. In 13 patients coronary revascularization was carried out as the first procedure. One patients died of a stroke following coronary artery surgery in the early postoperative period before carotid endarterectomy could be performed.