Standortbestimmung zur Frage der Simultan-Operation bei Patienten mit koronarer Herzkrankheit und extrakranieller cerebrovaskulärer Verschlußerkrankung

Ergebnisse einer Befragung von 62 deutschen Herzzentren
  • N. P. Körholz
  • H. H. Schmitt
  • K. Grabitz
  • W. Sandmann
  • H. D. Schulte
  • E. Gams
Originalarbeiten
Received:
Accepted:
  • 42 Downloads

Zusammenfassung

Die Indikationsstellung und das operative Vorgehen bei der Simultan-Operation ist uneinheitlich — dies wird durch die unterschiedlichen Letalitäts- und Morbiditätsraten der Herzzentren, die diese Operation durchführen, bestätigt. Der Zweck dieser Arbeit war es, anhand einer kurzen nationalen Umfrage zur Indikationsstellung und zum operativen Management eine Standortbestimmung für dieses Operationsverfahren in Deutschland zu geben.

Schlüsselwörter

KHK extrakranielle cerebrovaskuläre Verschlußerkrankung Krankenhaussterblichkeit Schlaganfallsrate Simultan-Operation 

Current status with regard to simultaneous carotid endarterectomy and coronary bypass surgery

Result of a survey of 62 german cardiovascular centers

Summary

Selection criteria for simultaneous coronary bypass-carotid endarterectomy (CABG-CEA) differ widely among the institutions and therefore the reported results of peri- and postoperative mortality and morbidity are different and irregular. The purpose of this article is to mirror current selection criteria and the surgical approach for CABG-CEA in Germany using a simple questionnaire mailed then to all existing German heart-centers, thus giving a current status with regard to this procedure.

Key words

Coronary artery disease extracranial carotid artery occlusive disease mortality stroke-rate combined approach 
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Berner BJ, Brief DK, Alpert J, Goldenkranz RJ, Parsonnet V (1987) The risk of stroke in patients with asymptomatic carotid stenosis undergoing cardiac surgery: a follow up study. J Vasc Surg 5: 269–277CrossRefGoogle Scholar
  2. 2.
    Bernhard VM, Johnson WD, Peterson JJ (1972) Carotid artery stenosis. Association with surgery for coronary artery disease. Arch Surg 105: 37–40Google Scholar
  3. 3.
    Breslau PJ, Fell G, Ivey TD, Baily WW, Miller DW, Strandness DE (1981) Carotid arterial disease in patients undergoing coronary artery bypass operations. J Thorac Cardiovasc Surg 82: 765–767PubMedGoogle Scholar
  4. 4.
    Carrol T, Stillhard G, Turina M (1992) Combined Carotid and Coronary Artery Surgery: Early and late results. Cardiology 1992, 80: 118–125CrossRefGoogle Scholar
  5. 5.
    Duchateau, Nevelsteen A, Sergeant P, Flameng W, Suy R (1989) Combined myocardial and cerebral revascularisation. A ten year experience. J Cardiovasc Surg 30: 715–722Google Scholar
  6. 6.
    Gardner TJ, Horneffer PJ, Hoff SJ, Pearson TA (1986) Major stroke after coronary artery bypass surgery: changing magnitude of the problem. J Vasc Surg 3: 684–687PubMedCrossRefGoogle Scholar
  7. 7.
    Hertzer NR (1982) Fatal myocardial infarktion following vascular operations. A study of 951 patients followed 6 to 11 years postoperatively. Cleve Clin Q 49: 1–11PubMedGoogle Scholar
  8. 8.
    Hertzer NR, Young JR, Beven EC (1985) Coronary angiography in 506 patients with extracranialcerebrovascular disease. Arch Intern Med 145: 849–852PubMedCrossRefGoogle Scholar
  9. 9.
    Hertzer NR, Loop FD, Beuen EG, O’Hara PJ, Krajewski LP (1989) Surgical staging forsimultaneous coronary and carotid disease: A study including prospective randomisation. J Vasc Surg Vol 9 No 3, March 1989: 455–463PubMedCrossRefGoogle Scholar
  10. 10.
    Ivey TD (1986) Combined carotid and coronary disease — A conservative strategy. J Vasc Surg Vol 3 No 4, April 1986: 687–689PubMedCrossRefGoogle Scholar
  11. 11.
    Kartchner MM, McRae LP (1982) Carotid occlusive disease as a risk factor in major cardiovascularsurgery. Arch Surg 117: 1086–1088PubMedGoogle Scholar
  12. 12.
    Mackey CW, Khabbaz K, Bojar R, O’Donnell Jr Th F (1996) Simultaneous carotid endarterectomy and coronary bypass: Perioperative risk and long-term survival. J Vasc Surg July 1996: 58Google Scholar
  13. 13.
    Minami K, Gawaz M, Ohlmeier H, Vyska K, Körfer R (1989) Management of concomitant occlusive disease of coronary and carotid arteries using cardiopulmonary bypass for both procedures. J Cardiovasc Surg 30: 723–728Google Scholar
  14. 14.
    Ricotta JJ, Faggioli GL, Castilone A, Hasset JM (1995) Risk factors for stroke after cardiacsurgery. Buffalo Cardiac Cerebral Study Group. J vasc surg Feb. Vol 21, No 2, 359–363CrossRefGoogle Scholar
  15. 15.
    Schlosser V, Fraedrich G, Seitelberger R, Schindler M, Hetzel A (1993) Combined stenosis of the supraaortic and coronary arteries: Indications for staged vs. simultaneous repair. Perspectives in Vasc Surg Vol 6, No 1Google Scholar
  16. 16.
    Sergeant P, Flameng W, Suy R (1988) The cerebrovascular risk in coronary surgery. Stroke 19: 18Google Scholar

Copyright information

© Steinkopff Verlag 1997

Authors and Affiliations

  • N. P. Körholz
    • 1
  • H. H. Schmitt
    • 1
  • K. Grabitz
    • 2
  • W. Sandmann
    • 2
  • H. D. Schulte
    • 1
  • E. Gams
    • 1
  1. 1.Klinik für Thorax- und KardiovaskularchirurgieHeinrich-Heine Universität DüsseldorfDüsseldorf
  2. 2.Klinik für Gefäßchirurgie und NierentransplantationHeinrich-Heine Universität DüsseldorfDüsseldorf

Personalised recommendations