Annals of Indian Academy of Neurology
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Year : 2015  |  Volume : 18  |  Issue : 4  |  Page : 419-423

Combining carotid endarterectomy with off-pump coronary artery bypass graft surgery is safe and effective

1 Institute of Neuroscience, Medanta The Medicity, Gurgaon, Haryana, India
2 Institute of Critical Care and Anesthesia, Medanta The Medicity, Gurgaon, Haryana, India
3 Department of Clinical Research, Medanta The Medicity, Gurgaon, Haryana, India
4 Medanta Heart Institute, Medanta The Medicity, Gurgaon, Haryana, India

Correspondence Address:
Arun Garg
B-111, Trinity Towers, DLF Phase 5, Gurgaon - 122 002, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-2327.165457

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Background: We, as neurologists, are frequently consulted to give neurological clearance for surgery in patients who are undergoing coronary artery bypass graft (CABG) surgery and have suffered from stroke or transient ischemic attack (TIA) in past. Similarly clearance is also sought in another group of patients who, though have not suffered from stroke or TIA, but found to have significant carotid stenosis on routine screening prior to surgery. Cardiac surgeons and anesthetists want to know the risk of perioperative stroke in such patients and should carotid endarterectomy (CEA) be done along with CABG. In absence of any clear-cut guideline, neurologists often fail to give any specific recommendation. Aim: To find out safety and efficacy of synchronous CEA in patients undergoing CABG. Design: Retrospective study. Materials and Methods: Out of 3,700 patients who underwent CABG, 150 were found to have severe carotid stenosis of >70%. Out of this, 46 patients with >80% stenosis (three symptomatic and 43 asymptomatic) and one patient with >70% symptomatic carotid stenosis (TIA within last 2 weeks) were taken for simultaneous CEA along with CABG. These three symptomatic carotid patients had suffered from stroke within last 6 months. Results: One patient with asymptomatic near total occlusion of carotid artery suffered from hyperperfusion syndrome. None suffered from ischemic stroke, myocardial infarction (MI), or death during perioperative period. Conclusion: Combining CEA along with CABG is a safe and effective procedure.

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