Simultaneous aorto-coronary bypass and carotid endarterectomy in acute myocardial infarction

Of 133 patients scheduled to elective myocardial revascularization in 4 patients coronary artery bypass surgery was performed urgently during acute myocardial infarction. In 2 of these 4 cases coronary bypass was combined with interventions on carotid arteries. In 1 patient with 90% stenosis of the left carotid artery endarterectomy Mras carried out, in the second patient segment of right internal carotid artery with 75% stenosis was resected and end to end anastomosis performed. There were no intraoperative complications. ECG signs of acute myocardial ischemia disappeared immediately after surgery and dynamics of ECG changes characteristic for postbypass period occurred. There were also no symptoms of cardiac or cerebro-vascular failure, A detailed case report of a patient subjected to simultaneous carotid endarterectomy and triple aorto-coronary bypass surgery with good immediate and long-term result is presented. Technique of anesthesia used in these cases is also described.