Experience with simultaneous myocardial revascularization and carotid endarterectomy.

Fifty-four patient had coexisting stenosis of the carotid artery (70% or greater) and coronary artery disease. Simultaneous carotid endarterectomy and myocardial revascularization were done in all cases. One permanent postoperative neurologic deficit occurred (1.9%). There were no deaths. Our experience with simultaneous correction of combined carotid and coronary disease leads us to conclude that simultaneous myocardial revascularization and carotid endarterectomy have low mortality and neurologic morbidity rates. The policy at Loyola University Medical Center at this time is to routinely perform simultaneous endarterectomy and myocardial revascularization in all patients with significant coexisting carotid and coronary disease.