Background: There is considerable controversy regarding the optimal management of patients undergoing cardiac surgery who are found to have an asymptomatic, unilateral carotid artery stenosis. Prior to 2004, the policy of this Unit was to perform a synchronous cardiac and carotid revascularisation. After January 2004, the policy was changed and patients underwent their cardiac procedure without carotid revascularisation. The aim of this study was to audit the incidence of stroke in the peri-operative period following this change in practice.
Methods: Five-year audit of the 30-day risk of stroke after 61 consecutive open cardiac procedures in patients with unilateral, asymptomatic 70-99% (NASCET) stenoses who did not undergo prophylactic carotid endarterectomy.
Results: 61 cardiac procedures; coronary artery bypass grafting (CABG)=44, valve replacement=6, CABG+valve replacement=9, CABG+repair of left ventricular aneurysm=2 were undertaken and the 30-day outcomes audited. There were three deaths (4.9%), all due to myocardial infarction. No strokes occurred in any patient in the 30-day post-operative period.
Conclusion: These results challenge the opinion that the presence of a unilateral, asymptomatic carotid stenosis in patients undergoing open cardiac surgery is associated with an increased risk of peri-operative stroke, sufficient to warrant routine prophylactic carotid revascularisation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ejvs.2009.08.001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Survival and oncological outcomes for young men (≤ 55 years) undergoing radical prostatectomy for localized prostate cancer.
Arch Ital Urol Androl
January 2025
Department of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz.
Objectives: This research aimed to compare the prostate cancer (PCa) features, survival rate, and functional outcomes after open suprapubic Radical Prostatectomy (RP) between younger men (≤ 55 years) and older men (> 55 years).
Methods: In this retrospective cohort study, we studied 134 patients with clinically localized PCa who underwent RP at our centers between 2011 and 2019, with 26 (19.40%) patients aged ≤ 55.
Ten years' single surgeon experience of excision and primary anastomosis urethroplasty for traumatic urethral stricture: an analysis of risk factors for urethral stricture recurrence.
Arch Ital Urol Androl
January 2025
Urology Department, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar General Hospital, Malang.
Introduction: Excision and primary anastomosis (EPA) urethroplasty is the standard treatment for traumatic urethral strictures, but managing them remains challenging for urologists. Identifying factors leading to EPA urethroplasty failure benefits both patients and surgeons. This study aims to analyze risk factors for urethral stricture recurrence after one-year follow-up of EPA urethroplasty.
View Article and Find Full Text PDFAccurate survival prediction of patients with long-bone metastases is challenging, but important for optimizing treatment. The Skeletal Oncology Research Group (SORG) machine learning algorithm (MLA) has been previously developed and internally validated to predict 90-day and 1-year survival. External validation showed promise in the United States and Taiwan.
View Article and Find Full Text PDFProximal humeral fractures (PHF), ranking as the third most common osteoporotic fractures, pose a significant challenge in management. With a rising incidence in an aging population, controversy surrounds surgical versus nonoperative treatments, particularly for displaced 3- and 4-part fractures in older patients. Locking plates (LP) and proximal intramedullary nails (PHN) are primary choices for surgical intervention, but both methods entail complications.
View Article and Find Full Text PDFThe objectives were to evaluate the effectiveness and safety of a single preoperative dose of intravenous tranexamic acid (TXA) in reducing perioperative blood loss and requirement for transfusion in patients undergoing hip hemiarthroplasty for femoral neck fracture. A double-blind randomized controlled trial was conducted in 140 patients with hip fracture. After randomization, 68 patients received a single dose of 1 gr of intravenous TXA at the start of the surgery (TXA group), and 72 received a placebo treatment (placebo group).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!