The Eternal Multidisciplinary Debate: Staged or Simultaneous Surgery? Patient with Polyvascular Disease Undergoing Carotid and Coronary Surgery

Abstract

Background: The combination of coronary and carotid artery disease is not rare since both entities share the same risk factors. However, when surgery is indicated for both pathologies, the question that remains is whether to opt for a simultaneous or staged surgery. Case Report: We report the case of a 73-year-old male, with a history of uncontrolled hypertension, dyslipidemia, diabetes and heavy smoking, admitted with an acute chest pain. Physical examination revealed bilateral carotid bruits especially at the right side. Electrocardiogram showed an ST depression in the anterior, lateral, inferior and posterior leads. Troponin was high. Trans-Thoracic Echocardiography showed an ischemic cardiopathy with preserved ejection fraction. Coronary angiography showed a triple-vessel disease requiring surgery. CT angiography of the neck showed a right carotid artery stenosis of 90 % also requiring surgery. He underwent a simultanous intervention with good outcomes. Conclusion: There are many debates about the choice of a simultaneous or staged surgery T the indications are still unclear. Multicentric studies must be carried out.