Abstract:

Purpose: Due to the characteristic of diffuse atherosclerosis, cerebrovascular disease and coronary artery disease can be found together. Some of the patients who go to cardiovascular surgery are at high risk of neurological events due to carotic arterial disease (CAH) and cerebrovascular disease. The most suitable operation strategy in patients with coronary arterial thinning (CABG) and simultaneous carothy arterial density (CAD) is still to be discussed. In this study, the combined surgical results (carotene endarterectomy [KEA] + KABG) were compared with isolated KABG in patients with KAH and the possible relationship between KAH and injury was evaluated. Tools and Methods: Between January 2017-April 2019, the medical files of a total of 480 patients with carotic artery Doppler ultrasound (USG) taken before the CABG were examined retrospectively. Demographic and clinical data of patients and carotenous arteric conditions identified with Doppler USG were recorded. Neurological complications during the stay in the hospital were assessed. Results: 312 of the patients were male and 168 female, with an average age of 62±10.4 (distribution: 44-78) years. 36 of the patients had a serious ADD. The pre-operative history of cerebrovascular events (P=0.048), older ages (P=0.002), passed KEA (P=0.576) and peripheral arterial disease (P=0.048) were statistically significantly higher in patients with severe KAD. Combined surgery was carried out on 21 of 36 patients with severe KAD. No neurological incident was observed in any of the patients performed by combined surgery. In 459 patients with isolated CABG, the total neurological mortality and morbidity rate during the stay in the hospital was 3.2%. The best results can be obtained with combined surgery (KEA+KABG) in patients with unstable angina, left main coronary arterial disease and common multi-vascular disease, along with severe KAD or symptomatic KAD.

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