Effect of carotid endarterectomy on cardiac function

Abstract

Objective To investigate the effect of carotid endarterectomy on cardiac function in order to reduce the occurrence of cardiac complications after procedure. Methods The preoperative cardiac function tests, blood pressure within 24 h after procedure, and changes in heart rate in 50 patients with carotid stenosis treated with carotid endarterectomy at the Department of Neurosurgery, the Fourth Affiliated Hospital of Guangxi Medical University from January 2012 to June 2013 were analyzed retrospectively. Results In 50 patients, 7 had a definite history of coronary heart disease. Routine electrocardiogram reported 18 had sinus bradycardia and/or some changes in myocardial ischemia, and echocardiography reported 41 had a mildly reduced left ventricular diastolic function. After procedure, 13 patients had decreased heart rate and blood pressure in different degrees, and 9 had cardiac function problems before procedure. Two of the 13 patients had acute coronary syndrome. They did not have any obvious clinical symptoms during hospitalization. They all improved and discharged from the hospital. One patient had extensive anterior myocardial infarction, and he died after active rescue. Conclusions Carotid endarteretomy has a greater impact on cardiac function. Strengthening the preoperative heart function examination, reducing intraoperatie injury of carotid sheath, actively managing the changes of postoperative heart rate, and blood pressure are critical for decreasing the disability and mortality. Key words: Endarterectomy, carotid; Carotid sinus; Parasympathetic nervous system; Heart