Universität zu Köln

Gerfer, Stephen ORCID: 0000-0002-6568-6766, Ivanov, Borko ORCID: 0000-0001-8052-8232, Krasivskyi, Ihor ORCID: 0000-0003-0573-8218, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Gaisendrees, Christopher ORCID: 0000-0002-7232-3330, Avgeridou, Soi, Kuhn-Regnier, Ferdinand, Mader, Navid, Rahmanian, Parwis, Kroener, Axel, Kuhn, Elmar and Wahlers, Thorsten . Heart surgery and simultaneous carotid endarterectomy-10-years single-center experience. Perfusion-UK. LONDON: SAGE PUBLICATIONS LTD. ISSN 1477-111X

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Abstract

Background Patients with coronary artery heart disease frequently suffer concomitant carotid vascular disease and are at high perioperative risk for neurological adverse events. Several concepts regarding the timing and modality of carotid revascularization are controversially discussed in patients with heart disease. Current guidelines recommendations on myocardial revascularization recommend a concomitant carotid endarterectomy (CEA) in patients with a history of stroke/transient ischemic attack (TIA) or 50-99% grade of the carotid stenosis. Our study aimed to analyze early outcome parameters of patients undergoing coronary artery bypass grafting (CABG), but also including concomitant heart valve surgery and simultaneous CEA. Methods This study retrospectively analyzed a cohort of 111 patients from our institutional database undergoing heart surgery with CABG or heart-valve surgery between 2010 and 2020 with concomitant carotid surgery due to significant carotid stenosis. Results Patients undergoing heart and simultaneous carotid surgery were 77 +/- 8.0 years of age with a body mass index of 28 +/- 1.7 kg/m(2) and a mean EuroSCORE II of 6.5 +/- 2.3. Most patients (61%) had a smoking history and arterial hypertension (97%). The preoperative mean grade of internal carotid stenosis was 87 +/- 4.2%, 13% of patients suffered from internal carotid artery stenosis on both sites. In total, 4.5% of patients had previously undergone internal carotid artery intervention before and 6.3% had a history of stroke with a persistent neurologic disorder in 1.8%, 8.9% of cases had prior TIA. Thirty-day all-cause mortality was 6.3% and postoperative neurologic events occurred with 7.2% TIA and 4.5% of disabling stroke. Conclusion Within the reported patient population of coronary artery heart disease and significant internal carotid stenosis, a one-time approach with CABG or heart-valve surgery and CEA is safe and feasible as justified by clinical and neurological postoperative outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gerfer, Stephen UNSPECIFIED orcid.org/0000-0002-6568-6766 UNSPECIFIED Ivanov, Borko UNSPECIFIED orcid.org/0000-0001-8052-8232 UNSPECIFIED Krasivskyi, Ihor UNSPECIFIED orcid.org/0000-0003-0573-8218 UNSPECIFIED Djordjevic, Ilija UNSPECIFIED orcid.org/0000-0002-5810-8626 UNSPECIFIED Gaisendrees, Christopher UNSPECIFIED orcid.org/0000-0002-7232-3330 UNSPECIFIED Avgeridou, Soi UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn-Regnier, Ferdinand UNSPECIFIED UNSPECIFIED UNSPECIFIED Mader, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroener, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-661852
DOI:	10.1177/02676591221114953
Journal or Publication Title:	Perfusion-UK
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	1477-111X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CORONARY-ARTERY-BYPASS; 2018 ESC/EACTS GUIDELINES; OUTCOMES; DISEASE; STROKE Multiple languages Cardiac & Cardiovascular Systems; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66185