Introduction: Treatment of combined coronary artery surgery (CABG) and severe carotid artery stenosis is still controversial. The decision of surgical priority can change according to the severity of the coronary arte...Introduction: Treatment of combined coronary artery surgery (CABG) and severe carotid artery stenosis is still controversial. The decision of surgical priority can change according to the severity of the coronary artery disease or carotid artery disease at staged surgery. The aim of the study is to compare the outcomes of simultaneous surgery (CEA + CABG) and CABG alone at our department. Materials and Methods: We retrospectively reviewed the CABG and CEA + CABG patients which were performed between 2010 and 2015. If the patients had simultaneous another operation, they were excluded from the study. A total of 294 patients (252 CABG patients and 42 combined surgery patients), were retrospectively examined. Results: Two patients in CABG group and two patients in CABG + CEA group developed stroke. There was no statistically significant difference between the two groups in terms of early stroke rate (p > 0.05). One patient in CEA + CABG group and three patients in CABG group died. The average carotid clamp time was 19.93 ± 5.06 minutes. Aortic clamp times were 42.89 ± 6.38 minutes in CABG and 42.81 ± 5.70 minutes in CEA + CABG patients. Results of the two groups were similar. Conclusion: Combined CEA and CABG can be performed successfully and safely in patients.展开更多
Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valv...Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valve replacement between January 2005 and July 2009 were included in this prospective study. In these patients, the insertion of prosthesis larger than the annulus diameter was attempted after the application of an external pressure that increased the transverse axis diameter of the aortic annulus. The postoperative results and complications were assessed. Results: This surgical method was performed on 22 patients (16 males, 6 females, mean age: 52.2 ± 15.8 years) during the valve replacement. In 12 patients (55%), replacement of proper sized aortic valve compliant to their surface area was accomplished, while the insertion of a proper valve could not be achieved in 10 (45%) of the patients. No perioperative mortality or complications related to the procedure were reported. Conclusion: Increasing the transverse diameter of aortic valve may not only facilitate the insertion of a prosthetic valve but also aid in overcoming prosthesis-patient mismatch. Further studies on larger series are necessary to document the actual effectively and precise selection criteria for application of this method.展开更多
文摘Introduction: Treatment of combined coronary artery surgery (CABG) and severe carotid artery stenosis is still controversial. The decision of surgical priority can change according to the severity of the coronary artery disease or carotid artery disease at staged surgery. The aim of the study is to compare the outcomes of simultaneous surgery (CEA + CABG) and CABG alone at our department. Materials and Methods: We retrospectively reviewed the CABG and CEA + CABG patients which were performed between 2010 and 2015. If the patients had simultaneous another operation, they were excluded from the study. A total of 294 patients (252 CABG patients and 42 combined surgery patients), were retrospectively examined. Results: Two patients in CABG group and two patients in CABG + CEA group developed stroke. There was no statistically significant difference between the two groups in terms of early stroke rate (p > 0.05). One patient in CEA + CABG group and three patients in CABG group died. The average carotid clamp time was 19.93 ± 5.06 minutes. Aortic clamp times were 42.89 ± 6.38 minutes in CABG and 42.81 ± 5.70 minutes in CEA + CABG patients. Results of the two groups were similar. Conclusion: Combined CEA and CABG can be performed successfully and safely in patients.
文摘Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valve replacement between January 2005 and July 2009 were included in this prospective study. In these patients, the insertion of prosthesis larger than the annulus diameter was attempted after the application of an external pressure that increased the transverse axis diameter of the aortic annulus. The postoperative results and complications were assessed. Results: This surgical method was performed on 22 patients (16 males, 6 females, mean age: 52.2 ± 15.8 years) during the valve replacement. In 12 patients (55%), replacement of proper sized aortic valve compliant to their surface area was accomplished, while the insertion of a proper valve could not be achieved in 10 (45%) of the patients. No perioperative mortality or complications related to the procedure were reported. Conclusion: Increasing the transverse diameter of aortic valve may not only facilitate the insertion of a prosthetic valve but also aid in overcoming prosthesis-patient mismatch. Further studies on larger series are necessary to document the actual effectively and precise selection criteria for application of this method.
