Özet:

Optimal surgical management of the patients with coronary and bilateral severe carotid artery diseaseis difficult and controversial. Presence of renal dysfunction in these patients makes the treatment evenmore challenging. We performed combined right carotid endarterectomy and off-pump coronary arterybypass grafting in a patient who had concomitant coronary artery disease, chronic renal failure, severe(60%) stenosis in the right internal carotid artery and total occlusion in the left internal carotid artery.There was neither neurological complication nor haemodialysis requirement in the perioperativeperiod. Combined carotid endarterectomy and coronary artery bypass grafting may be considered inthe patients who have concomitant coronary artery disease that requiring myocardialrevascularization, severe stenosis in the carotid artery and total occlusion in the contralateral carotidartery. We also think that beating heart off-pump coronary artery bypass grafting may be suitable formyocardial revascularization in the presence of preoperative renal dysfunction in these patients

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