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.

Effect of hypothermia in patients undergoing simultaneous carotid endarterectomy and coronary artery bypass graft surgery : cardiovascular topic

“…In a report on a small series of patients, neurological events occurred in one of 15 patients undergoing combined CEA and CABG under mild hypothermia. 15 Finally, Sadeghi et al 13 reported no early neurological outcomes and only one stroke during follow up when CEA was performed under mild hypothermia.…”

“…Some earlier studies implied the potential role of hypothermia as a preventative measure against adverse postoperative outcomes in patients undergoing single-stage on-pump CABG and CEA. 12 , 13 However, these studies fell short of their goal of determining whether hypothermia provides protection, because none of them involved a control group of patients undergoing CEA under normothermic conditions. In this study we sought to determine whether hypothermia provided any benefit in patients undergoing simultaneous CABG and CEA using one of two different surgical strategies.…”

High‐pressure Synthesis, Structure, IR Spectroscopy, and Theoretical Calculations of the New Silver Tetraborate Ag2B4O7 with a Unique Crystal Structure

“…Recently, Jansen and co‐workers discovered Ag 16 B 4 O 10 , featuring eight excess electrons per formula unit. Furthermore, Ag 2 O ⋅ 2 B 2 O 3 ⋅ 2 H 2 O ($${\widehat{=}}$$ Ag 2 B 4 O 7 ⋅ 2 H 2 O) and 2 Ag 2 O ⋅ 5 B 2 O 3 ⋅ 5 H 2 O were pointed out by Sadeghi in 1967 as well as Ag 2 O ⋅ 2 B 2 O 3 ($${\widehat{=}}$$ Ag 2 B 4 O 7 ) and Ag 2 O ⋅ 9 B 2 O 3 by Kocher and Sadeghi with no structural characterization [15,16] . Herein, we present the new silver tetraborate Ag 2 B 4 O 7 also exhibiting argentophilic interactions between the silver cations.…”