Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy
Background. Patients with simultaneous relevant internal carotid artery stenosis and coronary artery heart or valve disease represent a high-risk collective with respect to cerebral or cardiovascular severe events when undergoing surgery. There exist several concepts regarding the timing and modalit...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-08-01
|
| Series: | Journal of Cardiovascular Development and Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3425/10/8/330 |
| _version_ | 1797584343344873472 |
|---|---|
| author | Stephen Gerfer Walid Bennour Alina Chigri Ahmed Elderia Ihor Krasivskyi Clara Großmann Christopher Gaisendrees Borko Ivanov Soi Avgeridou Kaveh Eghbalzadeh Parwis Rahmanian Ferdinand Kuhn-Régnier Navid Mader Ilija Djordjevic Anton Sabashnikov Thorsten Wahlers |
| author_facet | Stephen Gerfer Walid Bennour Alina Chigri Ahmed Elderia Ihor Krasivskyi Clara Großmann Christopher Gaisendrees Borko Ivanov Soi Avgeridou Kaveh Eghbalzadeh Parwis Rahmanian Ferdinand Kuhn-Régnier Navid Mader Ilija Djordjevic Anton Sabashnikov Thorsten Wahlers |
| author_sort | Stephen Gerfer |
| collection | DOAJ |
| description | Background. Patients with simultaneous relevant internal carotid artery stenosis and coronary artery heart or valve disease represent a high-risk collective with respect to cerebral or cardiovascular severe events when undergoing surgery. There exist several concepts regarding the timing and modality of carotid revascularization, which are controversially discussed in patients with heart disease. More data regarding outcome predictors and measures are needed to gain a better understanding of the best treatment option of the discussed patient collective. Methods. This single-center study retrospectively analyzed <i>n</i> = 111 patients undergoing heart surgery with coronary artery bypass grafting or heart-valve surgery and concomitant carotid surgery due to significant internal carotid artery stenosis. In order to do so, patients were divided into two groups with respect to postoperative major adverse cardiac and cerebrovascular events (MACCE) with thirty-day all-cause mortality, valve related mortality, myocardial infarction, stroke and transitory ischemic attack. Results. Preoperative patient’s characteristic in the no-MACCE and MACCE group were mainly balanced, other than higher rates of chronic obstructive pulmonary disease, chronic kidney disease, instable angina pectoris and prior transitory ischemic attack in the MACCE cohort. The analysis of intraoperative characteristics revealed a higher number of intra-aortic balloon pump implantation, which is in line for a higher number of postoperative supports. Besides MACCE, patients suffered significantly more often from postoperative bleeding events and re-thoracotomy, cardiopulmonary reanimation, new onset postoperative dialysis and prolonged intensive care unit stay related complications. Conclusions. Within the reported patient population suffering from MACCE after a simultaneous carotid endarterectomy and heart surgery, a preoperative history of transitory ischemic attack and kidney disease might account for worse outcomes, as severe events were not only neurologically driven but also associated with postoperative cardiovascular complications following heart surgical procedures. |
| first_indexed | 2024-03-10T23:51:31Z |
| format | Article |
| id | doaj.art-807bce14018f4b11bd4175a4390f891b |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-10T23:51:31Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-807bce14018f4b11bd4175a4390f891b2023-11-19T01:38:06ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-08-0110833010.3390/jcdd10080330Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid EndarterectomyStephen Gerfer0Walid Bennour1Alina Chigri2Ahmed Elderia3Ihor Krasivskyi4Clara Großmann5Christopher Gaisendrees6Borko Ivanov7Soi Avgeridou8Kaveh Eghbalzadeh9Parwis Rahmanian10Ferdinand Kuhn-Régnier11Navid Mader12Ilija Djordjevic13Anton Sabashnikov14Thorsten Wahlers15Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyDepartment of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, 50937 Cologne, GermanyBackground. Patients with simultaneous relevant internal carotid artery stenosis and coronary artery heart or valve disease represent a high-risk collective with respect to cerebral or cardiovascular severe events when undergoing surgery. There exist several concepts regarding the timing and modality of carotid revascularization, which are controversially discussed in patients with heart disease. More data regarding outcome predictors and measures are needed to gain a better understanding of the best treatment option of the discussed patient collective. Methods. This single-center study retrospectively analyzed <i>n</i> = 111 patients undergoing heart surgery with coronary artery bypass grafting or heart-valve surgery and concomitant carotid surgery due to significant internal carotid artery stenosis. In order to do so, patients were divided into two groups with respect to postoperative major adverse cardiac and cerebrovascular events (MACCE) with thirty-day all-cause mortality, valve related mortality, myocardial infarction, stroke and transitory ischemic attack. Results. Preoperative patient’s characteristic in the no-MACCE and MACCE group were mainly balanced, other than higher rates of chronic obstructive pulmonary disease, chronic kidney disease, instable angina pectoris and prior transitory ischemic attack in the MACCE cohort. The analysis of intraoperative characteristics revealed a higher number of intra-aortic balloon pump implantation, which is in line for a higher number of postoperative supports. Besides MACCE, patients suffered significantly more often from postoperative bleeding events and re-thoracotomy, cardiopulmonary reanimation, new onset postoperative dialysis and prolonged intensive care unit stay related complications. Conclusions. Within the reported patient population suffering from MACCE after a simultaneous carotid endarterectomy and heart surgery, a preoperative history of transitory ischemic attack and kidney disease might account for worse outcomes, as severe events were not only neurologically driven but also associated with postoperative cardiovascular complications following heart surgical procedures.https://www.mdpi.com/2308-3425/10/8/330open heart surgeryCABGvalve surgerycarotid TEAcarotid endarterectomy |
| spellingShingle | Stephen Gerfer Walid Bennour Alina Chigri Ahmed Elderia Ihor Krasivskyi Clara Großmann Christopher Gaisendrees Borko Ivanov Soi Avgeridou Kaveh Eghbalzadeh Parwis Rahmanian Ferdinand Kuhn-Régnier Navid Mader Ilija Djordjevic Anton Sabashnikov Thorsten Wahlers Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy Journal of Cardiovascular Development and Disease open heart surgery CABG valve surgery carotid TEA carotid endarterectomy |
| title | Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy |
| title_full | Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy |
| title_fullStr | Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy |
| title_full_unstemmed | Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy |
| title_short | Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy |
| title_sort | major adverse cardiac and cerebrovascular events in patients undergoing simultaneous heart surgery and carotid endarterectomy |
| topic | open heart surgery CABG valve surgery carotid TEA carotid endarterectomy |
| url | https://www.mdpi.com/2308-3425/10/8/330 |
| work_keys_str_mv | AT stephengerfer majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT walidbennour majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT alinachigri majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT ahmedelderia majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT ihorkrasivskyi majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT claragroßmann majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT christophergaisendrees majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT borkoivanov majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT soiavgeridou majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT kaveheghbalzadeh majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT parwisrahmanian majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT ferdinandkuhnregnier majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT navidmader majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT ilijadjordjevic majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT antonsabashnikov majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy AT thorstenwahlers majoradversecardiacandcerebrovasculareventsinpatientsundergoingsimultaneousheartsurgeryandcarotidendarterectomy |