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Year : 2013  |  Volume : 16  |  Issue : 2  |  Page : 43-47

Prevalence of carotid artery disease in candidates undergoing coronary bypass graft seen at Madras Medical Mission

1 Department of Medicine, University College Hospital and University of Ibadan, Ibadan, Nigeria
2 Department of Adult Cardiology, Institutes of Cardiovascular Diseases, Madras Medical Mission, Chennai, India

Correspondence Address:
Abiodun M Adeoye
Department of Medicine, University College Hospital and University of Ibadan, Ibadan
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DOI: 10.4103/1118-8561.115254

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Background: Significant carotid artery disease in candidates going for coronary artery bypass graft (CABG) increases the risk of developing peri-operative neurologic events. Therefore, a pre-operative carotid Doppler ultrasonography, which is simple, non-invasive, and cheap may be indispensable. In this study, we report the prevalence of carotid disease in candidates for CABG and assessed the correlates between carotid artery disease and coronary artery disease (CAD). Materials and Methods: Seventy three consecutive patients undergoing elective CABG were recruited over 7 months, January to July 2007. All participants underwent pre-operative carotid Doppler assessment for level of stenosis and site of carotid plaque. Using the criteria defined by the Society of Radiologists in the Ultrasound Consensus, the degree of stenosis was stratified into the categories of normal (no stenosis), 50% non-obstructive carotid disease, 50-69% significant stenosis, 70% critical stenosis to near occlusion, near occlusion, and total occlusion. Patients with previous CABG, congestive cardiac failure, and high-risk surgery were excluded. Results: The mean age of patients was 65.0 ± 7.2 years with male-female ratio of 9:1. Twenty one (28.8%) patients had normal carotid arteries 45 (61.6%) had non-obstructive carotid artery disease 4 (5.5%) had significant carotid stenosis and 3 (4.1%) had critical carotid stenosis. Carotid bulb was the most common site of plaque formation while left internal carotid artery was the commonest site of both significant and critical carotid stenosis. Patients with significant carotid artery disease had 3 times the odd of having severe CAD (left main disease/triple vessel disease). However, this was not statistically significant (OR 2.75, P = 0.284). Conclusion: The high frequency of carotid artery disease in this study underscores the need for routine ultrasonic carotid assessment in candidates for CABG to ensure early detection and prompt management of carotid disease in a candidate of CABG which may prevent untoward peri-operative neurologic events.

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