دورية أكاديمية
Carotid shunt provides cerebral protection during emergency coronary artery bypass grafting in a patient with bilateral high grade carotid stenosis: a case report
| العنوان: | Carotid shunt provides cerebral protection during emergency coronary artery bypass grafting in a patient with bilateral high grade carotid stenosis: a case report |
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| المؤلفون: | Gougoulakis Alexandros, Kiriazis Charalampos, Kogerakis Nektarios, Bellos John K, Panagiotou Matthew |
| المصدر: | Journal of Cardiothoracic Surgery, Vol 6, Iss 1, p 33 (2011) |
| بيانات النشر: | BMC, 2011. |
| سنة النشر: | 2011 |
| المجموعة: | LCC:Surgery LCC:Anesthesiology |
| مصطلحات موضوعية: | Surgery, RD1-811, Anesthesiology, RD78.3-87.3 |
| الوصف: | Abstract Background Management of patients with co-existent coronary and carotid disease is a controversial and challenging issue. The risk for stroke after coronary artery bypass grafting (CABG) in patients with hemodynamically significant carotid stenosis is up to 30%. In these patients a common practice is to proceed first with the restoration of cerebral perfusion and then perform the coronary revascularization. The rationale is that this strategy will reduce perioperative neurological morbidity and mortality. However, what happens when the carotid procedure is acutely complicated by cardiac instability which necessitates the interruption of the carotid procedure? Case report We describe a case of a patient with unstable angina and high grade asymptomatic bilateral carotid stenosis who underwent emergency combined CABG and carotid endarterectomy (CEA). Due to hemodynamic instability, ST-T changes, hypotension and bradycardia, upon completion of endarterectomy we placed a carotid shunt and the patient was put on cardiopulmonary bypass through median sternotomy. After triple CABG (duration of 90 minutes) we concluded the interrupted CEA procedure with primary closure of the carotid arteriotomy with the shunt in place. The postoperative course was uneventful and the patient was discharged after a week. In extreme cases with bilateral severe carotid stenosis and coronary artery disease where the carotid procedure should be interrupted, we suggest the use of carotid shunt which can provide adequate cerebral perfusion giving time to cardiac surgeon to perform the life saving cardiac procedure first. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1749-8090 |
| Relation: | http://www.cardiothoracicsurgery.org/content/6/1/33; https://doaj.org/toc/1749-8090 |
| DOI: | 10.1186/1749-8090-6-33 |
| URL الوصول: | https://doaj.org/article/f04bff4329db4da29e128d3420383767 |
| رقم الأكسشن: | edsdoj.f04bff4329db4da29e128d3420383767 |
| قاعدة البيانات: | Directory of Open Access Journals |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 17498090 |
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| DOI: | 10.1186/1749-8090-6-33 |