To find out safety and efficacy of synchronous CEA in patients undergoing CABG. Methods: Out of 711 patients who underwent CABG, 48 were found to have severe carotid stenosis of >70%. Out of this, 18 patients with >70% stenosis (thirteen symptomatic and five asymptomatic) and one patient with >70% symptomatic carotid stenosis (TIA within last 2 weeks) were taken for simultaneous CEA along with CABG. These three symptomatic carotid patients suffered from stroke within last 6 months. Results: None suffered from myocardial infarction (MI) during perioperative period.Postoperative recovery period-13,5 ± 0,8 days. During the follow-up period of 12 months, one patient died of cardiovascular causes (stroke). Conclusion: Combined carotid and coronary arteries disease's incidence in this series was 6,3%. Simultaneous carotid and off-pump coronary artery bypass surgery is safe and effective method of treatment patients with severe concomitant carotid artery stenosis and ischemic heart disease with relatively low mortality rate.
Iatrogenic aortic dissection (IAD) is a very rare but dangerous complication, which can occur during or after open cardiac surgery, complex percutaneous coronary intervention (PCI), thoracic endovascular aortic aneurysm repair (TEVAR) or transaortic valve replacement (TAVR). Accord-ing to literature, IAD is observed three times more fre-quently during off pump (OPCAB) than conventional coro-nary bypass grafting (CABG). It is also associated with a higher mortality and represents a huge challenge to all cardiovascular professionals including cardiac surgeons who encounter this clinical outcome. Here we present a case of intraoperative Stanford type A aortic dissection during off-pump coronary artery bypass.
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