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Combined carotid endarterectomy and coronary artery bypass graft surgery for a critically compromised carotid and coronary disease patient.


Darwin James G. Alvarez

Related Institution

Cardiovascular Anesthesia - Philippine Heart Center

Publication Information

Publication Type
Research Project
January 1-December 1, 2014


Background --- Carotid endarterectomy (CEA) and coronary artery bypass (CABG) surgery as a single stage procedure has an increased risk for stroke and perioperative myocardial infarction. This is a case report on the anesthetic challenges and management of a patient undergoing combined CEA and CABG.
Case --- This is a case of a 63-year old man who came In for chest pain. Coronary angiography revealed a severe triple vessel disease with critical left main involvement. He was also diagnosed with a totally occluded left distal internal carotid artery and 70-99% right internal carotid artery stenosis with type V plaque morphology and a history of cerebral vascular accident (CVA) 2 years prior to this presentation. He underwent a combined CEA and CABG procedure under IABP and CPB pump support. He did not have any major adverse event and was discharged improved.
Conclusion --- The use of preoperative IABP, neurologic monitors and employing neuroprotective measures in combined CEAlCABG on patients withseverely compromised coronary and carotid arteries may improve the outcome.

Physical Location

LocationLocation CodeAvailable FormatAvailability
Philippine Heart Center Medical Library CR.007.14 Fulltext Print Format

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