心血管疾患と診断

Early off Pump Coronary Artery Bypass Grafting After Carotid Artery Stenting is Safer than on Pump Coronary Artery Bypass Grafting in Male Patients

Abstract

Tamer Owais, Mohammad El-Garhy, Ashraf Fawzy, Alaa Eldin Farouk, Mahmoud Eldin, Farouk Elalfy, Martin Breuer and Thomas Kuntze

Objectives: Our aim was to evaluate and compare the safety and reliability of the early coronary bypass operation either with off-pump or on-pump technique after carotid artery stenting (CAS) in ischemic patients.

Patients and methods: The data of 312 patients with combined coronary and carotid artery disease treated with CAS between 2010 and 2017 prior to CABG in two different centers: Saudi German Hospital in Saudi Arabia and central clinic Bad Berka in Germany were retrospectively reviewed. 189 patients were operated off-pump; they were referred to as group A. The remaining 123 patients were operated on-pump (group B). All patients were submitted for CAS hours before the CABG. In both groups the double antiplatelet therapy was given before and after the carotid stenting and continued after the CABG. Patients in both groups were investigated pre-and postoperative by CT brain and CT angiography of carotid artery. Patients were followed up for stroke, bleeding, MI and mortality for 2 years.

Results: Patients of group A had less mortality, less post-operative bleeding, less myocardial infraction and less stroke after CABG than those in group B. The early timing for the CAS prior to CABG was more safe and reliable in group A.

Conclusion: Early Off-pump CABG after CAS is safer for patients; with fewer complications and less mortality than in On-pump CABG.