Routine preoperative carotid Doppler ultrasonography in patients undergoing coronary artery bypass grafting

Abstract

Objective: The purpose of this study is to determine carotid artery involvement, predictive parameters for significant carotid artery disease and those patients needed to carotid endarterectomy (CEA) in patients undergoing coronary artery bypass grafting (CABG). Material and Methods: In our clinic, 88 patients undergoing CABG operation electively during the period between May and December 2002 were included in this study. Mean age was 61.86 ± 9.14 [32min-82max]. All of the patients were screened routinely with carotid Doppler ultrasonography preoperatively. ? 70% stenosis in carotid artery was accepted as critic carotid artery disease (CCAD). The patients with significant carotid artery disease (SCAD) [? 50% stenosis] in group-I compared to the patients with non-significant carotid artery disease (NSCAD) [< 50% stenosis] in group-II regarding to age, sex, hipertension (HT), diabetes mellitus (DM), smoking, peripheral arterial disease (PAD), left main coronary artery (LMCA) disease, number of diseased coronary artery (DCA) and number of distal anastomosis (DA). CEA was performed simultaneously with CABG operation. Fisher's exact test and independent sample t test were used for statistical analysis. Results: Carotid artery involvement was detected in 81.8% but CCAD in 5.7% of the patients. CEA was performed in 3.4% of the patients, none of this patients had no cardiac or neurologic morbidity and mortality. Mean age of the patients (66 ± 6.4/60.9 ± 9.1, p= 0.091), PAD (40%/12.8%, p= 0.063) and LMCA disease (30%/8.9%, p= 0.062) in group-I were higher than that of the patients in group-II but not statistically significant. There were no significant differences between group-I and II regarding to sex, HT, DM, smoking, DCA. However, diffuse coronary artery disease in group-I (DA= 3.7 ± 0.82/2.89 ± 0.74, p= 0.002) was significantly higher than that of in group II. Early postoperative mortality rate was 2.3% and post-CABG major stroke rate was 1.1%. Conclusion: In conclusion, we advise to screen routinely with carotid Doppler ultrasonography in patients undergoing CABG operation with diffuse coronary artery disease. Copyright © 2005 by Türkiye Klinikleri.