Combined carotid endarterectomy and coronary bypass: a decade experience at UCLA

Purpose: The purpose of this review was to determine outcomes for combined carotid endarterectomy (CEA) and coronary revascularization (CABG) in patie nts with asymptomatic carotid stenosis, Methods: We reviewed the medical records of consecutive combined procedures (CEA and CABG), performed at UCLA Medical Center from October, 1989 to Jan uary, 1999. Findings: There were 43 patients, 27 men and 16 women, with a mean age of 7 1 yr (range 51-87). Thirty-four patients 79% (34/43) had asymptomatic carot id stenosis. Stroke occurred in three patients (3/43 = 6.9%), Stroke ipsila teral to the CEA occurred in two patients: one asymptomatic (1/34 = 2.9%) a nd one symptomatic (1/9 = 11.1%). Conclusions: The majority of patients undergoing combined CEA/CABG have asy mptomatic carotid stenosis identified in preparation for elective CABG, The asymptomatic carotid subset stroke rate of 2.9% resulting from a combined CEA/CABG is higher than our reported rate for CEA performed alone. In patie nts with asymptomatic carotid stenosis, the combined procedure should be se lectively performed. (C) 2001 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd, All rights reserved.