Abstract
Background Atherosclerosis is a pathological process involving blood vessels all over the body in varying intensity. Occurrence of significant carotid artery disease in patients requiring coronary artery bypass grafting (CABG) results in a dilemma regarding the best surgical strategy for addressing both. Our objective was to compare the efficacy of synchronous carotid endarterectomy(CEA) and CABG with staged CEA followed by CABG. Methods During a four year period, from April 2013 to March 2017, 42 patients underwent CEA with CABG. Of these, 20 patients underwent synchronous procedure (group 1), and 22 underwent staged procedures (group 2) within 30 days apart. Results 42 patients underwent CEA with CABG either in synchronous or staged fashion. In synchronous group, 2 patients (10%) had stroke, 3 patients (15%) had reversible ischemic neurological deficit and 4 patients (20%) had convulsions. In the staged group, one patient (4.5%) required re-exploration for bleeding, 1 patient (4.5%) had stroke and 1 patient (4.5%) had convulsions. The result was found to be statistically significant on comparing group 1 with group 2. Conclusion Synchronous and staged procedures have their own merits and demerits. Patients with critically stenosed coronary and carotid artery lesions with accompanying severe comorbidities should preferably undergo synchronous procedures with CEA followed by CABG and staged procedures should be reserved for patients with chronic stable angina with lesser comorbidities.
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