Introduction
Coronary bypass surgery is a surgical method for the coronary heart
disease’s treatment. Despite its widespread use, the operation can have
several complications, the most devastating of which is a postoperative
stroke. The developing ACVA(acute cerebrovascular accident) 30-day risk
after CABG (coronary artery bypass grafting) is 1.1% [1]. In the
carotid artery damage’s presence, the ACVA risk increases to 2.75%, and
the 30-day mortality risk is 2.59% [2]. Coronary heart disease is
the main death cause in patients with the carotid arteries’
atherosclerotic lesions [3].
Patients who have undergone CEA(carotid endarterectomy) have a higher
risk of developing MI(myocardial infarction) than ACVA, and patients
with postoperative MI have a 5-year survival rate of only 56% [4].
To date, there aren’t high-class evidence recommendations for the
patients’ treatment with the coronary and brachiocephalic arteries’
combined atherosclerotic lesions. The ESC/ESVS Recommendations for the
peripheral artery diseases’ diagnosis and treatment in 2017 regarding
the coronary and carotid arteries’ combined atherosclerosis contain the
provision: for the carotid artery revascularization in patients
requiring CABG, an individual indications discussion (and if any, the
method and time) is recommended for each patient by a multidisciplinary
specialists’ team , including a neurologist (class I, level C) [5].
ESC/EACTS recommendations on myocardial revascularization in 2018 on
this issue repeat the recommendations for the patients with peripheral
artery disease’s management in 2017 [6]. We want to present our
treating this cohort of patients’ experience, to show immediate and
long-term results.