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Year : 2000  |  Volume : 1  |  Issue : 10  |  Page : 402-407

Incidence of carotid lesions in patients undergoing coronary artery bypass graft

1 Doctorate in Cardiological Sciences, Second University of Naples, Naples, Italy
2 Institute of Cardiac Surgery, Second University of Naples, Naples, Italy
3 Division of Vascular Surgery, V. Monaldi Hospital, Naples, italy, Italy
4 Division of Vascular Surgery, V. Monaldi Hospital, Naples, ITALY

Correspondence Address:
Attilio Renzulli
via Aquila 144, 80143, Naples
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Source of Support: None, Conflict of Interest: None

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Atherosclerotic involvement of extracoronary arteries in patients undergoing myocardial revascularization can cause severe postoperative complications and increase postoperative mortality. When associated vascular lesions are detected preoperatively, appropriate operative approach, perfusion technique, and postoperative treatment can be planned and thus reduce the risk of perioperative stroke. In order to assess the incidence and the degree of associated vascular lesions, we performed routine preoperative echo-Doppler study of carotid vessels in all patients who were candidates for coronary artery bypass graft (CABG) between January and November 1998. Correlations between echo-Doppler findings, angiographic patterns of coronary lesions, and atherosclerotic risk factors were analyzed in all cases. Among 302 patients undergoing CABG, 186 (61.6%) had carotid disease, with a significant lesion in 31 (10.2%). Twenty-three patients (7.6%) had asymptomatic severe carotid disease. Whenever a significant carotid lesion was found, carotid endoarterectomy (CEA) was performed under local anaesthesia before CABG. A significant correlation between severity of coronary disease and incidence of severe carotid disease was found (p=0.02). Symptoms of carotid disease are not reliable as predictors of perioperative risk of stroke in patients undergoing CABG. In order to plan suitable operative approach and to prevent perioperative vascular complications, non-invasive carotid investigation should be routinely performed in such patients.

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