Aorto-left common carotid artery bypass with off-pump coronary artery bypass

Abstract

Background Although carotid artery disease can occur in patients who have coronary artery disease (CAD), ostial stenosis of a left common carotid artery (CCA) along with CAD is a rarely reported condition. Case report We describe a rare case of severe stenosis of the left CCA ostium and CAD, which were successfully treated with an off-pump coronary artery bypass and aorto-left CCA bypass. This strategy minimizes the risk of perioperative strokes. Furthermore, an aorto-supra aortic trunk bypass provides a more physiological blood flow pattern than cerebral approaches. This approach would be a safe and effective treatment option.

Important points in the combined supra-aortic vessel and coronary artery revascularization

“…We read with interest the article 1 entitled “Aorto-left common carotid artery bypass with off-pump coronary artery bypass”. We would like to congratulate the authors for their valuable contribution to the literature.…”

“…3 Advanced imaging techniques evaluating carotid plaque structure can be used. 4 In this case, 1 since the degree of stenosis is close to occlusion, it can be assumed that there will be no risk of distal embolization even if the plaque structure is bad. In the case series in which old polytetrafluoroethylene (PTFE) grafts were used, care was taken to exclude plaque-containing structures in the bifurcation region from the internal carotid artery.…”

“…6 However, we observed a subtle ITA calibration in the control computed tomographic angiography (CTA) (Figure 2B). 1 What could be the reason for this? In addition, a severe plaque structure is observed in the region close to the beginning of the left subclavian artery in the preoperative CTA (Figure 1A) 1 images.…”

“…1 What could be the reason for this? In addition, a severe plaque structure is observed in the region close to the beginning of the left subclavian artery in the preoperative CTA (Figure 1A) 1 images. On the other hand, in the control CTA (Figure 2B) 1 an image of this as leading to significant stenosis emerges more clearly.…”