Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2025; 22 (4): 287-382 ➤ Безопасное сочетание каротидной эндартерэктомии и аортокоронарного шунтирования off-pump у пациентов с высоким риском сердечно-сосудистых осложнений

Safe combination of carotid endarterectomy and coronary artery bypass grafting off-pump in patients at high risk of cardiovascular complications

Authors: Darvish N.A., Merzlyakov V.Yu., Ivashchenko V.E., Eseneev M.F., Shogenov M.A., Valieva R.R., Vasilkov A.S., Shumilina M.V.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2025-22-4-320-328

UDC: 616.132.2-089.86-059:616.132.2-089.819]-07

Link: Clinical Physiology of Blood Circulaiton. 2025; 22 (4): 320-328

Quote as: Darvish N.A., Merzlyakov V.Yu., Ivashchenko V.E., Eseneev M.F., Shogenov M.A., Valieva R.R., Vasilkov A.S., Shumilina M.V. Safe combination of carotid endarterectomy and coronary artery bypass grafting off-pump in patients at high risk of cardiovascular complications. Clinical Physiology of Circulation. 2025; 22 (4): 320–328 (in Russ.). DOI: 10.24022/1814-6910-2025-22-4-320-328

Keywords:  acute cerebrovascular event myocardial infarction mortality MACE carotid endarterectomy off-pump coronary artery bypass grafting

Received / Accepted:  16.10.2025 / 01.12.2025

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Abstract

Objective. To determine the efficacy of one-stage operations (carotid and coronary revascularization) and identify risk factors influencing major adverse cardiovascular even (MACE) in patients with asymptomatic and symptomatic cerebral ischemia.

Material and methods. An analysis of combined operations performed from 2013 to 2024 was conducted in 245 patients with asymptomatic and symptomatic ischemic manifestations of the brain.

Results. Acute cerebrovascular events were registered in 5 (2,0%) cases, myocardial infarction in 2 (0.8%) cases, and mortality accounted for 2 (0.8%) cases. Two significant, independent factors influencing MACE were identified: 1. Preoperative ejection fraction less than 53% OR 35.5 (95% CI 3.5–361.9), p = 0.003; 2. Stay in the intensive care unit for more than three days OR 13.5 (95% CI 1.1–165.5), p = 0.042.

Conclusion. According to the study, the incidence of an adverse event after a one-stage operation is low (less than 3%). It was also found that patients with preoperative left ventricular ejection fraction less than 53% potentially have a 13-fold increased risk of adverse events (MACE), while a stay in the intensive care unit for more than 3 days increases the risk of MACE by 35 times.

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  1. Weimar C., Bilbilis K., Rekowski J., Holst T., Beyersdorf F., Breuer M. et al. Safety of simultaneous coronary artery bypass grafting and carotid endarterec-tomy versus isolated coronary artery bypass grafting a randomized clinical trial. Stroke. 2017; 48 (10): 2769–2775. DOI: 10.1161/СТРОКЕАХА.117.017570
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About Authors

  • Nidal A. Darvish, Cand. Med. Sci., Senior Researcher, Head of the Department; ORCID
  • Vadim Yu. Merzlyakov, Dr. Med. Sci., Head of the Department, Cardiovascular Surgeon; ORCID
  • Vsevolod E. Ivashchenko, Researcher, Cardiovascular Surgeon; ORCID
  • Mussa F. Eseneev, Researcher, Cardiovascular Surgeon; ORCID
  • Mukhamed A. Shogenov, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
  • Ramilya R. Valieva, Researcher, Cardiologist; ORCID
  • Artem S. Vasilkov, Cardiovascular Surgeon; ORCID
  • Margarita V. Shumilina, Dr. Med. Sci., Head of the Department, Ultrasound Diagnostics Doctor; ORCID

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