Background: The aim of the study was to evaluate the results of carotid artery endarterectomy due to stenoses affecting cerebro-vascular circulation in patients before cardiac surgery.
Material and methods: Patients with stable (46 pts.) or unstable (35 pts.) ischaemic heart disease and more than 70% stenosis (both symptomatic and asymptomatic) of the carotid internal artery were included in the study group. The first stage of surgical treatment (a carotid artery endarterectomy) was performed at the Department of Vascular Surgery. 3–14 days later the patients underwent CABG in the Centre of Cardiovascular Surgery in Zabrze. In patients with unstable ischaemic heart disease, an endarterectomy and CABG were performed in the Centre of Cardiovascular Surgery on the same day (in 5 patients endarterectomy under regional anesthesia was performed before CABG, 2 others underwent endarterectomy followed by CABG under general anesthesia) or within 2–3 day interval. Diagnostic procedures, therapeutic indications, the management and the results of the treatment were analysed.
Results: None of the endarterectomies resulted in death. One of the patients undergoing an endarterectomy due to the stenosis of the internal cartoid artery and occlusion of the brachiocephalic trunk and cardiovascular surgery during the same day, died one day after the operation due to cardiac complications.
Conclusions: In all patients before CABG, the carotid arteries should be examined. In cases of stenosis affecting cerebro-vascular circulation, a preventive endarterectomy should be performed.