Objective: Due to the diffuse nature of atherosclerosis, cerebrovascular, and coronary artery disease may present simultaneously. A proportion of the patients undergoing cardiac surgery are at an increased risk for carotid artery disease (CAD) related neurological events. The ideal operation strategy is still controversial in patients with concomitant carotid artery stenosis (CAS) undergoing coronary artery bypass grafting (CABG). In this study, we aimed to evaluate the outcomes of isolated CABG versus combined surgery (CEA+CABG) in patients with CAD and to identify the possible correlation between CAD and stroke.

Materials and Methods: Between January 2017 and April 2019, medical files of a total of 480 patients who underwent carotid artery Doppler ultrasonography before CABG were retrospectively analyzed. Demographic and clinical data of the patients and carotid artery status as assessed by Doppler USG were recorded. Neurological complications were evaluated during the hospital stay.

Results: Of the patients, 312 were males and 168 were females with a mean age of 62±10.4 (range: 44 to 78) years. A statistically significantly higher number of patients with severe CAD had a preoperative history of cerebrovascular accident (P=0.048), advanced age (P=0.002), prior CEA (P=0.576), and peripheral artery disease (P=0.048). Of 36 patients with severe CAD, 21 underwent combined surgery. None of the patients treated with CEA+CABG had neurological events. The neurological in-hospital mortality and morbidity was 3.2% in 459 patients with isolated CABG.

Conclusion: Combined surgery can yield the most favorable outcomes in patients with severe CAD or symptomatic CAD accompanied by unstable angina, left main coronary artery disease, and multi-vessel disease.