OBJECTIVE

To present own results of coronary artery bypass surgery in patients with coronary artery disease and severe extra- and intracranial lesions of carotid arteries unsuitable for carotid endarterectomy.

MATERIAL AND METHODS

We analyzed 33 patients with combined lesions of coronary and carotid arteries. Mean age was 65.9±6.7 years. All ones had severe angina pectoris CCS class III—IV. In 12.1% of cases, LV ejection fraction was less than 40%. Almost all patients (93.9%) were diagnosed with multiple-vessel lesion of coronary arteries, and more than half of them (51.5%) had stenosis of the left main coronary artery. Diffuse extra- and intracranial lesions of internal carotid arteries were observed in 57.6% of patients (unilateral — 30.3%, bilateral — 27.3%). Occlusion of one internal carotid artery was diagnosed in 36.4% of cases (no lesion of contralateral internal carotid artery — 27.3%, diffuse lesion — 9.1%). Occlusion of both internal carotid arteries was found in 6.1% of patients.

RESULTS

Mean surgery time was 228±56 min, hospital-stay — 12.1±2.3 days. There were no perioperative infarctions. One patient developed stroke with subsequent fatal outcome. In-hospital mortality was 3.0%.

CONCLUSION

Off-pump coronary artery bypass surgery may be performed with acceptable risk in patients with coronary artery disease and diffuse extra- and intracranial carotid artery lesions unsuitable for carotid endarterectomy.