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首页> 外文期刊>Brazilian Journal of Cardiovascular Surgery >Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy
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Comparison of Early Outcomes with Three Approaches for Combined Coronary Revascularization and Carotid Endarterectomy

机译：三种方法联合进行冠状动脉血运重建和颈动脉内膜切除术的早期结果比较

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Abstract Objective: This study aims to compare three different surgical approaches for combined coronary and carotid artery stenosis as a single stage procedure and to assess effect of operative strategy on mortality and neurological complications. Methods: This retrospective study involves 136 patients who had synchronous coronary artery revascularization and carotid endarterectomy in our institution, between January 2002 and December 2012. Patients were divided into 3 groups according to the surgical technique used. Group I included 70 patients who had carotid endarterectomy, followed by coronary revascularization with on-pump technique, group II included 29 patients who had carotid endarterectomy, followed by coronary revascularization with off-pump technique, group III included 37 patients who had coronary revascularization with on-pump technique followed by carotid endarterectomy under aortic cross-clamp and systemic hypothermia (22-27oC). Postoperative outcomes were evaluated. Results: Overall early mortality and stroke rate was 5.1% for both. There were 3 (4.3%) deaths in group I, 2 (6.9%) deaths in group II and 2 (5.4%) deaths in group III. Stroke was observed in 5 (7.1%) patients in group I and 2 (6.9%) in group II. Stroke was not observed in group III. No statistically significant difference was observed for mortality and stroke rates among the groups. Conclusion: We identified no significant difference in mortality or neurologic complications among three approaches for synchronous surgery for coronary and carotid disease. Therefore it is impossible to conclude that a single principle might be adapted into standard practice. Patient specific risk factors and clinical conditions might be important in determining the surgical tecnnique.
机译：摘要目的：本研究旨在比较三种将冠状动脉和颈总动脉狭窄合并为一个单一阶段的手术​​方法，并评估手术策略对死亡率和神经系统并发症的影响。方法：这项回顾性研究纳入了我院2002年1月至2012年12月间同步进行冠状动脉血运重建和颈动脉内膜切除术的136例患者。根据所使用的手术技术将患者分为3组。第一组包括70例行颈动脉内膜切除术的患者，然后采用泵技术进行冠状动脉血运重建，第二组包括29例经颈动脉内膜切除术的患者，然后进行非泵技术进行冠状动脉血运重建，第三组包括37例行颈动脉内膜切除术的患者。泵技术，然后在主动脉夹钳和全身低温（22-27oC）下进行颈动脉内膜切除术。评估术后结果。结果：两者的总体早期死亡率和中风率均为5.1％。第一组死亡3（4.3％），第二组死亡2（6.9％），第三组死亡2（5.4％）。 I组中有5例（7.1％）患者发生卒中，II组中有2例（6.9％）患者发生中风。在第三组中未观察到中风。各组之间的死亡率和中风发生率均无统计学差异。结论：我们发现在三种同时进行的冠状动脉和颈动脉疾病手术方法中，死亡率或神经系统并发症没有显着差异。因此，不可能得出一个结论，那就是单一的原则可能适用于标准实践。患者特定的危险因素和临床状况可能对确定手术技术很重要。

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