Concomitant carotid endarterectomy and off-pump coronary artery bypass grafting in coexistent carotid and coronary artery diseases

Aim: To analyze the results of our experience with a combined procedure via off-pump coronary artery bypass (OPCABG) and carotid endarterectomy (CEA) retrospectively. Materials and methods: Eighty-four patients underwent OPCABG and CEA concomitantly between 1998 and 2011. Thirty (35.7%) patients had a cardiac history of myocardial infarction (MI), 13 (15.6%) had unstable angina (USAP), and 27 (32.1%) had USAP together with MI, whereas 14 (16.6%) were asymptomatic. Forty-two (50%) patients showed no neurological symptoms, 20 (23.8%) had transient ischemic attacks (TIAs), 21 (25%) suffered from stroke, and 1 (1.2%) experienced both. CEA was performed before OPCABG in all of the patients. Results: There were 84 patients (aged 68.05 ± 5.88; 77.3% male). Four (4.8%) had a perioperative stroke whereas 5 of them had TIAs (5.9%). Mean ICU stay was 30.3 h and patients were discharged in 6.4 days on average. There were 2 (2.38%) postoperative myocardial infarctions and 3 (3.5%) deaths in the early postoperative period. Conclusion: A combined procedure via OPCABG and CEA seems to be safe and cost effective based on the acceptable results of morbidity and mortality rates and short ICU and hospital stays.