A direct comparison of early and late outcomes with three approaches to carotid revascularization and open heart surgery. [1]
Significant carotid artery disease is not uncommon in patients undergoing open heart surgery (OHS). Whether to treat both conditions in a staged or combined procedure remains an unresolved matter. In this retrospective study, the authors compared outcomes in three groups of patients according to treatment strategies: staged carotid endarterectomy (CEA) followed by OHS (CEA-OHS), combined CEA-OHS (i.e. concomitant CEA and OHS under a single anesthesia), and staged carotid stenting (CAS) followed by OHS (CAS-OHS) No significant difference in the primary composit endpoint(all-cause death, stroke, and myocardial infarction) was found between staged CAS-OHS and combined CEA-OHS in the short term. However, beyond 12 months, the staged CAS-OHS option appears to be a better choice. Staged CEA-OHS has the highest risk during both early and late phases. These findings were consistent regardless of multiple adjustments using propensity score and propensity matching.
Source name:
Journal of the American College of Cardiology
Resource link:
Taxonomy2018 vocabulary term reference:
Cardiac [5]