[Immediate and intermediate results of staged carotid endarterectomy in combination with coronary artery bypass grafting].

The purpose of our investigation was to evaluate the immediate and intermediate results of staged operations of carotid endarterectomy and coronary artery bypass grafting in patients with multifocal atherosclerosis. We analysed a total of 475 operations. Of these, 371 (78.1%) patients underwent staged interventions (stage 1 - carotid endarterectomy, stage 2 - coronary artery bypass grafting). No neurological complications were observed after stage 1. Five (1.3%) patients developed cardiac arrhythmia in the form of atrial fibrillation, 7 (1.9%) were found to have transient neuropathy of cranial nerves. There were no lethal outcomes. Stage 2 was carried out 16±13 days after carotid endarterectomy. Of complications encountered, mention should be made of perioperative myocardial infarction in 1 (0.3%) patient, with 2 (0.6%) patients requiring emergency coronary bypass angiography. Newly onset atrial fibrillation was registered in 71 (19.1%) patients, haemorrhage followed by resternotomy in 6 (1.6%), and purulent wound complications in 4 (1.1%) patients. Death occurred in 1 (0.3%) patient. We also analysed the mid-term postoperative results (up to 32 months). The coverage amounted to 151 patients. The incidence rate of major adverse cardiac and cerebrovascular events (MACCE) was 6% (myocardial infarction - 2, acute cerebral ischaemia - 1, repeat myocardial revascularization - 5, lethal outcome - 1). Based on the obtained findings it may be concluded that staged operations on the carotid basin and coronary arteries by the number of complications are comparable to those after isolated coronary artery bypass grafting.