OPEN HEART SURGERY OR CAROTID ENDARTERECTOMY. WHICH PROCEDURE SHOULD BE DONE FIRST?

Introduction: Ischemic stroke is a predictable complication of cardiac surgery specially in patients with previous diagnosed carotid stenosis. On the other side, patients undergoing carotid endarterectomy with concomitant significant valvular or coronary artery disease, may face worst peri-operativ...

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Main Authors: Pedro Pinto Sousa, Gabriela Teixeira, Pedro Sá Pinto, Luis Vouga, Rui Almeida
Format: Article
Language:Portuguese
Published: Sociedade Portuguesa de Angiologia e Cirurgia Vascular 2020-12-01
Series:Angiologia e Cirurgia Vascular
Subjects:
Online Access:https://acvjournal.com/index.php/acv/article/view/281
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author Pedro Pinto Sousa
Gabriela Teixeira
Pedro Sá Pinto
Luis Vouga
Rui Almeida
author_facet Pedro Pinto Sousa
Gabriela Teixeira
Pedro Sá Pinto
Luis Vouga
Rui Almeida
author_sort Pedro Pinto Sousa
collection DOAJ
description Introduction: Ischemic stroke is a predictable complication of cardiac surgery specially in patients with previous diagnosed carotid stenosis. On the other side, patients undergoing carotid endarterectomy with concomitant significant valvular or coronary artery disease, may face worst peri-operative outcomes.  Objective: Analyzing outcomes from a pool of patients with both comorbidities wondering which procedure should be conducted first.  Material and Methods: Retrospective analysis of a group of patients submitted to carotid endarterectomy (Group I) between January 2011 and December 2017 that concomitantly presented coronary artery or valvular disease. Outcomes comparison with a group of patients submitted to cardiac surgery (Group II) that concomitantly presented carotid stenosis.  Results: There was no statistically significant difference in patient stroke risk-factors between groups.  Adverse events rate difference between groups did not reach statistical significance (stroke 1,7% vs 2,8% p=0,698; Acute myocardial infarct 1,7% vs 2,8% p=0,698, death 0% vs 4,6% p=0,073).  Discussion: Handling these specific pools of patients is still debatable. Both interventions demand a multidisciplinary approach so as an experienced surgery and anaesthesiology team to individually select which approach fits each patient better. 
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spelling doaj.art-f0e0117c2bd64f2ba5f22fd918e459bf2023-01-16T09:01:55ZporSociedade Portuguesa de Angiologia e Cirurgia VascularAngiologia e Cirurgia Vascular1646-706X2183-00962020-12-0116310.48750/acv.281OPEN HEART SURGERY OR CAROTID ENDARTERECTOMY. WHICH PROCEDURE SHOULD BE DONE FIRST?Pedro Pinto SousaGabriela TeixeiraPedro Sá PintoLuis VougaRui Almeida Introduction: Ischemic stroke is a predictable complication of cardiac surgery specially in patients with previous diagnosed carotid stenosis. On the other side, patients undergoing carotid endarterectomy with concomitant significant valvular or coronary artery disease, may face worst peri-operative outcomes.  Objective: Analyzing outcomes from a pool of patients with both comorbidities wondering which procedure should be conducted first.  Material and Methods: Retrospective analysis of a group of patients submitted to carotid endarterectomy (Group I) between January 2011 and December 2017 that concomitantly presented coronary artery or valvular disease. Outcomes comparison with a group of patients submitted to cardiac surgery (Group II) that concomitantly presented carotid stenosis.  Results: There was no statistically significant difference in patient stroke risk-factors between groups.  Adverse events rate difference between groups did not reach statistical significance (stroke 1,7% vs 2,8% p=0,698; Acute myocardial infarct 1,7% vs 2,8% p=0,698, death 0% vs 4,6% p=0,073).  Discussion: Handling these specific pools of patients is still debatable. Both interventions demand a multidisciplinary approach so as an experienced surgery and anaesthesiology team to individually select which approach fits each patient better.  https://acvjournal.com/index.php/acv/article/view/281Carotid endarterectomyOpen heart surgeryCarotid stenosisStrokeCombined surgeryCoronary event
spellingShingle Pedro Pinto Sousa
Gabriela Teixeira
Pedro Sá Pinto
Luis Vouga
Rui Almeida
OPEN HEART SURGERY OR CAROTID ENDARTERECTOMY. WHICH PROCEDURE SHOULD BE DONE FIRST?
Angiologia e Cirurgia Vascular
Carotid endarterectomy
Open heart surgery
Carotid stenosis
Stroke
Combined surgery
Coronary event
title OPEN HEART SURGERY OR CAROTID ENDARTERECTOMY. WHICH PROCEDURE SHOULD BE DONE FIRST?
title_full OPEN HEART SURGERY OR CAROTID ENDARTERECTOMY. WHICH PROCEDURE SHOULD BE DONE FIRST?
title_fullStr OPEN HEART SURGERY OR CAROTID ENDARTERECTOMY. WHICH PROCEDURE SHOULD BE DONE FIRST?
title_full_unstemmed OPEN HEART SURGERY OR CAROTID ENDARTERECTOMY. WHICH PROCEDURE SHOULD BE DONE FIRST?
title_short OPEN HEART SURGERY OR CAROTID ENDARTERECTOMY. WHICH PROCEDURE SHOULD BE DONE FIRST?
title_sort open heart surgery or carotid endarterectomy which procedure should be done first
topic Carotid endarterectomy
Open heart surgery
Carotid stenosis
Stroke
Combined surgery
Coronary event
url https://acvjournal.com/index.php/acv/article/view/281
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AT luisvouga openheartsurgeryorcarotidendarterectomywhichprocedureshouldbedonefirst
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