Associated vascular lesions in patients undergoing coronary artery bypass grafting

CIRILLO, Francesca; RENZULLI, Attilio; LEONARDO, Giuseppe; ROMANO, Gianpaolo; DE FEO, Marisa; DELLA CORTE, Alessandro; CRESCENZI, Basili; COTRUFO, Maurizio

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Document Details :

Title: Associated vascular lesions in patients undergoing coronary artery bypass grafting
Author(s): CIRILLO, Francesca , RENZULLI, Attilio , LEONARDO, Giuseppe , ROMANO, Gianpaolo , DE FEO, Marisa , DELLA CORTE, Alessandro , CRESCENZI, Basili , COTRUFO, Maurizio
Journal: Acta Cardiologica
Volume: 56 Issue: 2 Date: April 2001
Pages: 91-96
DOI: 10.2143/AC.56.2.2005623

Abstract :
Atherosclerotic involvement of extracoronary arteries in patients undergoing myocardial revascularization can cause severe postoperative complications and increase postoperative mortality.
Between January and November 1998,routine preoperative echo-Doppler study of carotid vessels, abdominal aorta and iliac-femoral arteries was performed in all patients undergoing coronary artery bypass grafting (CABG) at our institution,in order to assess the prevalence and the degree of associated vascular lesions.Correlations between echo-Doppler findings,angiographic patterns of coronary lesions and atherosclerotic risk factors were analyzed in all cases. Among 302 patients undergoing CABG, 186 (61.6%) had carotid disease, with a haemodynamically significant stenosis (> 70%) of internal carotid in 31 (10.2%).Twenty-three patients had asymptomatic severe carotid disease. A significant correlation between severity of coronary disease and prevalence of severe carotid disease was found (p = 0.02).
An abdominal aortic dilatation (diameter > 25 mm) was found in 20 cases (6.6%), with a diameter > 35 mm in 7 patients (2.3%),6 with triple-vessel coronary disease,and 1 with double-vessel disease. Atherosclerotic lesions of iliac-femoro-popliteal axis were found in 165 (54.6%) patients, with a strong correlation to the severity of coronary disease (p = 0.02); lesions were haemodynamically significant (> 70%) in 48 (15.8%) cases.
Symptoms of carotid and peripheral vascular disease are no reliable predictors of perioperative risk in patients undergoing CABG.Non-invasive complete arterial investigation should be routinely performed in these patients,in order to plan the most suitable operative approach and to prevent peri-operative vascular complications.