scholarly journals Clinical Outcomes of Synchronous Laparoscopic Cholecystectomy with Coronary Artery Revascularization

2019 ◽  
Vol 22 (3) ◽  
pp. E229-E233 ◽  
Author(s):  
Dogan Kahraman ◽  
Ihsan Sami Uyar ◽  
Umit Duman ◽  
Ibrahim Sami Karaca ◽  
Dilek Dogan ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Coronary Revascularization ◽  
Intubation Time ◽  
Time Duration ◽  
Cabg Surgery ◽  
Icu Stay ◽  
Group I ◽  
The Mean

Background: There are limited data about the results of simultaneous coronary revascularization, either with coronary artery bypass grafting (CABG) surgery or percutaneous coronary intervention (PCI), and cholecystectomy operations. Here we present clinical outcomes of the patients who underwent simultaneous laparoscopic cholecystectomy (LC) and coronary revascularization at the same session. Patients and Methods: We included a total of 19 patients who underwent simultaneous LC and CABG or PCI. Thirteen of them had been hospitalized because of acute cholecystitis prior to coronary angiography. Simultaneous CABG and LC were performed in 10 patients (group I). LC was performed immediately after CABG surgery at the same session. PCI (group II) was performed in 9 patients. In the PCI group, LC was performed under general anesthesia 2 or 3 days after PCI. Results: No mortality was seen after the procedures. In the CABG group, the mean number of bypass grafts was 3.4 ± 1.9. The mean extracorporeal circulation and the total operation times were 95 ± 13.5 minutes and 259 ± 18.9 minutes, respectively; the mean intubation duration was 17 ± 4.8 hours. In the PCI group, the mean number of stents per patient was 2.1 ± 0.7; LC was performed 2 or 3 days after the PCI without the cessation of clopidogrel and acetylsalicylic acid. The mean operation times for LC were 56.5 ± 15.6 minutes and 51.3 ± 17.6 minutes in the CABG and PCI groups, respectively (P = .86). In the CABG group, the mean durations of ICU and hospital stays were 3.1 ± 1.4 and 14.2 ± 3.7 days, respectively. In the PCI group, the mean durations of ICU stay and hospitalization were 1.7 ± 0.4 and 7.4 ± 2.2 days, respectively. Significant differences were found between the 2 groups in terms of the intubation time, duration of ICU stay, and hospitalization periods (P =.001, P =.0001, and P =.001, respectively). No intra-abdominal complications or bleeding was encountered in any group. Postoperative complications of the abdominal wall or mediastinitis were not seen in the setting of concomitant procedures in the CABG group. Conclusion: Simultaneous CABG or PCI with LC may be performed safely in patients with cholecystitis. The durations of postcholecystectomy ICU stay and the intubation time were significantly lower in the PCI group. According to our results, PCI may be the first choice of revascularization procedure in selected patients requiring cholecystectomy prior to discharge.

scholarly journals Progenitor Cells for Arterial Repair: Incremental Advancements towards Therapeutic Reality

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Trevor Simard ◽  
Richard G. Jung ◽  
Pouya Motazedian ◽  
Pietro Di Santo ◽  
F. Daniel Ramirez ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Progenitor Cells ◽  
Clinical Outcomes ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Obstructive Coronary Artery Disease ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Therapeutic Modality ◽  
Vascular Repair

Coronary revascularization remains the standard treatment for obstructive coronary artery disease and can be accomplished by either percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery. Considerable advances have rendered PCI the most common form of revascularization and improved clinical outcomes. However, numerous challenges to modern PCI remain, namely, in-stent restenosis and stent thrombosis, underscoring the importance of understanding the vessel wall response to injury to identify targets for intervention. Among recent promising discoveries, endothelial progenitor cells (EPCs) have garnered considerable interest given an increasing appreciation of their role in vascular homeostasis and their ability to promote vascular repair after stent placement. Circulating EPC numbers have been inversely correlated with cardiovascular risk, while administration of EPCs in humans has demonstrated improved clinical outcomes. Despite these encouraging results, however, advancing EPCs as a therapeutic modality has been hampered by a fundamental roadblock: what constitutes an EPC? We review current definitions and sources of EPCs as well as the proposed mechanisms of EPC-mediated vascular repair. Additionally, we discuss the current state of EPCs as therapeutic agents, focusing on endogenous augmentation and transplantation.

scholarly journals Prolonged QTc Dispersion Correlates with Coronary Artery Disease in Acute ST Elevated Myocardial Infarction (STEMI)

2013 ◽  
Vol 5 (2) ◽  
pp. 173-181 ◽  
Author(s):  
NI Sharafat ◽  
M Khalequzzaman ◽  
M Akhtaruzzaman ◽  
AK Choudhury ◽  
S Hasem ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Qt Dispersion ◽  
Qtc Dispersion ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Artery Disease ◽  
Vessel Score ◽  
Vessel Involvement

Background: It has been found that there is strong association of QT dispersion and QT dispersion ratio with extent and severity of coronary artery disease. Qualitative importance of QTc dispersion on the base line ECG in patients with MI is recognized clinically but quantification of this phenomenon is less commonly used in clinical practice, which might be a better independent risk predictor of this group of patients. Methods: A total of 100 patients were selected, Study populations sub-divided into two groups on the basis of QTc dispersion. In group I (comparison group): QTc dispersion is <60 milliseconds (msec) in group II (study group) : QTc dispersion e”60milliseconds(msec). 50 patients in each group. QT dispersion was calculated on standard resting 12 lead ECGs. QT interval was measured from the beginning of the inscription of the QRS complex to the point at which the T wave returned to the isoelectric line. Angiographic severity of coronary artery disease was assessed by- Vessel score, Friesinger score and Leaman score. Interpretation of coronary angiogram was reviewed by at least two cardiologists. . Results: The mean vessel score for group I patients was 1.16±0.68 and that of group II patients was 2.30±0.64 and the mean difference was statistically significant (p<0.05). Patients those had single vessel involvement had mean QTc dispersion 57.05, patients those had double vessel disease mean QTc dispersion was 102.00 and patients those had triple vessel involvement had mean QTc dispersion 177.60. There was a strong positive correlation with the QTc dispersion and increasing number of vessel involvement (Pearson’s correlation coefficient). The mean Friesinger score for group I patients was 4.84±2.56 and that of group II patients was 9.80±2.60. The mean difference was significantly (p<0.05) higher in group II patients. There was a strong positive correlation between the QTc dispersion and Leaman score (Pearson’s correlation coefficient). In group I patients 56% had insignificant coronary artery disease and 44% had significant coronary artery disease defined by Friesinger index (n=100). In group II patients 6% had Insignificant coronary artery disease & had 94% significant coronary artery disease. Conclusion: QTc dispersion>60 ms had independent predictive value for the severity of coronary artery disease. The greater the QTc dispersion the higher the number of coronary artery involvement. We observed that there is a positive correlation between prolonged QT dispersion and coronary artery disease severity in terms of Vessel score, Friesinger score, Leaman score. DOI: http://dx.doi.org/10.3329/cardio.v5i2.14322 Cardiovasc. j. 2013; 5(2): 173-181

scholarly journals Sex specificities of medical and social parameters in patients with coronary artery disease with different severity of depression

2021 ◽  
Vol 20 (1) ◽  
pp. 2425
Author(s):  
Yu. V. Nagibina ◽  
M. I. Kubareva ◽  
D. S. Knyazeva
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Class Ii ◽  
Mental Condition ◽  
Class Iii ◽  
Group I ◽  
Severity Of Depression ◽  
The Mean ◽  
Group Ii ◽  
Artery Disease

Aim. To determine the sex specificities of medical and social parameters in patients hospitalized due to coronary artery disease (CAD), class II, III, IV angina, aged 35-60 years and assess the significance of their relationship with different levels of depression.Material and methods. The study involved 312 patients aged 35-60 with documented CAD, class II, III, IV angina. Two comparison groups were identified: group I — 138 patients (men, 81; women, 57) with CAD and without depression (mean age, 47,8±4,6 years); group II — 174 patients (men, 60; women, 105) with CAD and depression (mean age, 48,3±5,3 years). Medical and social data, the severity of depression and distress tolerance, psychological status and quality of life was assessed. Statistical analysis was carried out, which are presented as the mean and standard error of the mean (M±m). The odds ratio (OR) and 95% confidence interval (CI) were calculated. Differences were considered significant at p<0,05.Results. The prevalence of depression among patients with CAD was 55,77%, while women were 1,5 times more likely to suffer it than men. Depression was significantly associated with hyperglycemia, hypercholesterolemia, and class III-IV angina, regardless of sex. Class III and IV angina prevailed in women, while class II angina — in men (OR, 2,16; 95% CI, 1,37-3,41, p<0,001)). Women were more prone to degree II-III disability (group II, 26,67%; group I 8,77%; p=0,008), compared with men (group II, 27,54%; group I, 11,11%; p=0,012). Sedentary lifestyle was also associated to a greater extent with the female sex than with the male (OR, 2,89, 95% CI, 1,46-5,70, p=0,003; OR, 2,31, 95% CI, 1,19-4,48; p=0,014, respectively). Both men and women showed a significant association of depression with atherosclerosis (p<0,001), however, sex differences did not reach significance. Indicators such as lack of job and higher education, as well as smoking and arrhythmias were characteristic of both sexes, but had a greater impact on the mental condition of men (p=0,002, p<0,001, p=0,0014 and p=0,01, respectively). For men, the relationship of depression with diabetes (8,7 vs 0%; p=0,008), obesity (42,03 vs 19,75%; p=0,004), subordinate status (82,61 vs 64,2%; p=0,016) and unmarried status (60,87 vs 40,74%; p=0,02).Conclusion. There are significant differences in factors contributing to depression in different sex groups. The association of depression with CAD has an adverse effect on the physical and psychological health of both males and females. At the same time, women are more prone to mental disorders than men. It is necessary to further study the sex characteristics of medical and social parameters in order to personalize treatment methods.

scholarly journals Long-Term Clinical Outcomes of Fractional Flow Reserve-Guided Coronary Artery Revascularization in Chronic Kidney Disease

2022 ◽  
Vol 12 (1) ◽  
pp. 21
Author(s):  
Chien-Boon Jong ◽  
Tsui-Shan Lu ◽  
Patrick Yan-Tyng Liu ◽  
Jeng-Wei Chen ◽  
Ching-Chang Huang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Fractional Flow Reserve ◽  
Primary Endpoint ◽  
Coronary Revascularization ◽  
Fractional Flow ◽  
Flow Reserve

Fractional flow reserve (FFR)-guided percutaneous coronary intervention has shown favorable long-term clinical outcomes. However, limited data exist evaluating the FFR assessment among the chronic kidney disease (CKD) population. The aim of this study was to evaluate the long-term clinical outcomes of FFR-guided coronary revascularization in patients with CKD. A total of 242 CKD patients who underwent FFR assessment were retrospectively analyzed. Patients were divided into two groups: revascularization (FFR ≤ 0.80) and non-revascularization (FFR > 0.80). The primary endpoint was the composite of cardiac death, non-fatal myocardial infarction, and target vessel failure (TVF). The key secondary endpoint was TVF. The Cox regression model was used for risk evaluation. With 91% of the ischemic vessels revascularized, the revascularization group had higher risks for both the primary endpoint (adjusted hazard ratio [aHR]: 2.06; 95% confidence interval [CI], 1.07–3.97; p = 0.030) and key secondary endpoint (aHR: 2.19, 95% CI: 1.10–4.37; p = 0.026), during a median follow-up of 2.9 years. This result was consistent among different CKD severities. In patients with CKD, functional ischemia in coronary artery stenosis was associated with poor clinical outcomes despite coronary revascularization.

Abstract 462: Effect of Coronary Revascularization on Plasma Level of Asymmetric Dimethylarginine

2014 ◽  
Vol 34 (suppl_1) ◽  
Author(s):  
Adam Nemeth ◽  
Zsofia Lenkey ◽  
Zeno Ajtay ◽  
Attila Cziraki ◽  
Endre Sulyok ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Plasma Levels ◽  
Time Course ◽  
Asymmetric Dimethylarginine ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cabg Surgery ◽  
Off Pump ◽  
Group I

Background: Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide synthase. Increased ADMA plasma levels are associated with atherosclerosis and cardiovascular disease. In this study we investigated the plasma levels of ADMA in patients who underwent different type of coronary revascularization. Methods: Concentrations of ADMA, l-arginine, symmetric dimethylarginine (SDMA) were measured by liquid chromatography-tandem mass spectrometry in four groups: group I consisted of 16 patients with ST-elevation myocardial infarction (STEMI), and group II included 24 patients who underwent elective percutaneous coronary intervention (PCI). Before PCI and at 1 hour, 5 days and 30 days after reperfusion blood samples were taken for measurement of l-arginine, ADMA and SDMA. Group III consisted of 21 patients undergoing off-pump and group IV included 20 patients undergoing on-pump coronary artery bypass graft (CABG) surgery. The measurements were performed 24 h before, 3 times during the operation (via coronary sinus catheter), and on the 1st and 5th postoperative day. Results: In patients with elective stent implantation stenting induced a prompt and sustained depression of ADMA (F=9.594, p<0.001), however ADMA remained constant for STEMI patients after stent placement (F=2.982, p=0.069). The differences in the time-course for ADMA (F=9.431, p<0.001) proved to be significant between the two groups. We did not find significant change in the plasma concentration of ADMA during off-pump CABG surgery (F=0.416, p=0.68), however ADMA concentration increased significantly in patients who underwent on-pump surgery both in the coronary sinus (F=14.751, p<0.001) and peripheral blood (F=30.738, p<0.001). Therefore, the intersubject time effect, was significant (F=6.990, p=0.002). Conclusions: The main finding of the present study is that the response pattern of the new cardiovascular risk factor, ADMA was significantly different between the two PCI and the CABG groups. Its long-term follow-up may be suitable to monitor the improvement of coronary function after revascularisation. This method should be feasible to monitor of the ADMA metabolism during coronary revascularization.

Phẫu thuật cầu nối chủ vành ở bệnh nhân có tiền sử can thiệp mạch vành qua da tại Bệnh viện Trung ương Huế

2021 ◽  
Author(s):  
An Vinh Bui Duc
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Bypass Grafting ◽  
Cabg Surgery ◽  
Percutaneous Coronary

TÓM TẮT Đặt vấn đề: Can thiệp mạch vành qua da là lựa chọn điều trị đối với bệnh lý động mạch vành trong những trường hợp hẹp một hoặc hai nhánh động mạch vành, hội chứng vành cấp. Số lượng các trường hợp can thiệp mạch gia tăng dẫn đến ngày càng có nhiều bệnh nhân nhập viện phẫu thuật bắc cầu chủ vành đã có tiền sử can thiệp mạch vành. Nghiên cứu này nhằm mục tiêu 1) nhận diện các yếu tố nguy cơ phẫu thuật của các bệnh nhân có chỉ định tái tưới máu vào viện với tiền sử can thiệp mạch vành trước đó và 2) đánh giá kết quả phẫu thuật bắc cầu chủ vành ở nhóm bệnh nhân này. Đối tượng, phương pháp: Bệnh nhân có tiền sử can thiệp mạch vành qua da được phẫu thuật chương trình bắc cầu chủ vành tại Bệnh viện Trung Ương Huế. Nghiên cứu hồi cứu, mô tả. Kết quả: Trong giai đoạn từ 1/2012 - 1/2017, có 16 bệnh nhân được phẫu thuật. Tuổi trung bình là 64,6 ± 8,2, trung bình BMI - 24,7 ± 1,8, thời gian phẫu thuật sau can thiệp qua da trung bình 2 năm. Các yếu tố nguy cơ bao gồm: tăng huyết áp 87,5%, đái tháo đường 81,3%, rối loạn lipid máu 68,8%, hút thuốc lá 62,5%. Tất cả các bệnh nhân đều có triệu chứng của đau thắt ngực ổn định với 62,5% xếp loại CCS IV. Thời gian tuần hoàn ngoài cơ thể trung bình 125,3 ± 19,5 phút trong đó 37,5% không sử dụng tuần hoàn ngoài cơ thể. Phẫu thuật bắc cầu chủ vành ở nhiều vị trí chiếm đa số 87,5%. Quá trình hậu phẫu ghi nhận các biến chứng: chảy máu (43,8%), rung nhĩ (12,5%), tai biến mạch máu não (6,25%). 1 trường hợp đặt bóng đối xung trong thời gian hậu phẫu. Thời gian nằm viện trung bình 27,4 ± 8,5 ngày. Không ghi nhận tử vong trong quá trình nằm viện và sau 6 tháng theo dõi. Kết luận: Các yếu tố nguy cơ ảnh hưởng đến kết quả phẫu thuật đối với bệnh nhân có chỉ định tái tưới máu vào viện có tiền sử can thiệp mạch vành gồm hút thuốc lá, tăng huyết áp, đái tháo đường, thời gian phẫu thuật sau can thiệp mạch vành, số lượng mạch vành đã can thiệp, số mạch vành cần tái tưới máu và phân suất tống máu thất trái. Phẫu thuật bắc cầu chủ vành là phương pháp điều trị đem lại kết quả tốt ở các bệnh nhân này trong ngắn hạn. Từ khóa: Can thiệp mạch vành qua da, bắc cầu chủ vành, tái tưới máu ABSTRACT CORONARY ARTERY BYPASS GRAFTING AMONG PATIENTS WITH PRIOR PERCUTANEOUS CORONARY INTERVENTION AT HUE CENTRAL HOSPITAL Background: Percutaneous coronary intervention (PCI) is the preferred treatment modality for single and double vessel coronary artery disease and in the setting of acute coronary syndrome. The rising volume of PCI is directly proportional to the representation of patients hospitalized for coronary artery bypass graft (CABG) surgery who have a history of previous PCI procedures. This study aims to 1) identify the risk factors in patients requiring revascularization with prior PCI and 2) evaluate the surgical outcomes. Materials and method: This is a retrospective case series of patients with prior PCI undergoing elective CABG surgery at Hue Central Hospital. Results: From January 2012 and January 2017, 16 patients operated. The mean age was 64.6 ± 8.2. Mean Body Mass Index was 24.7 ± 1.8. The PCI and CABG gap was 2 years. Coronary risk factors including hypertension (87.5%), diabetes mellitus (81.3%), dyslipidemia (68.8%) and smoke (62.5%). All patients presented stable angina with 62.5% CCS class IV. Mean cardiopulmonary bypass time was 125.3 ± 19.5 minutes, 37.5% off - pump coronary surgery. Multi - bypass bypass grafting was performed in 87.5%. Surgical complications were recognized, including 43.8% bleeding, 12.5% atrial fibrillation, and 6.25% stroke. A case required an intra - aortic balloon pump during the postoperative period. Mean hospital stay was 27.4 ± 8.5 days. There was no mortality during hospitalization and 6 - month follow - up. Conclusion: Risk factors for surgical outcome in patients requiring coronary revascularization with prior PCI include diabetes mellitus, smoking, hypertension, time of CABG surgery after PCI, previously intervened vessels, coronary revascularization strategies, and left ventricular ejection fraction. CABG is an appropriate modality for reperfusion in these patients with positive early outcomes. Keywords: Percutaneous coronary intervention, coronary artery bypass grafting, revascularization.

Surgical Stress Response and Clinical Outcomes of Single Port Laparoscopic Cholecystectomy: Prospective Nonrandomized Study

2012 ◽  
Vol 78 (4) ◽  
pp. 485-491 ◽  
Author(s):  
Hyung Joon Han ◽  
Sae Byeol Choi ◽  
Wan Bae Kim ◽  
Jin-Suk Lee ◽  
Yoon Jung Boo ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Stress Response ◽  
Pain Score ◽  
Clinical Outcomes ◽  
Single Port ◽  
Operation Time ◽  
Conventional Group ◽  
Conventional Laparoscopic ◽  
Laparoscopic Cholecystectomy Group ◽  
The Mean

The levels of interleukin-6 (IL-6) are proportionate to injury; it is the most commonly used quantitative marker in surgical studies. Cytokines and the acute-phase response play an important role in controlling the human immune system. The objective of this study was to compare the systemic acute cytokine response and clinical outcomes of conventional laparoscopic and single port laparoscopic cholecystectomy. We compared patients who underwent single port laparoscopic cholecystectomy (the single port group) with patients who underwent conventional laparoscopic cholecystectomy (the conventional group) according to the clinical variables, IL-6, leukocyte subpopulations, and visual analog scale (VAS) pain score. The mean age in the single port group was significantly younger ( P = 0.010) and the mean operation time in the conventional group was significantly shorter ( P = 0.002). Postoperative 4-hour VAS pain score was slightly worse in the single port laparoscopic cholecystectomy group, but was not significantly different. We found no difference in clinical outcomes, the level of serum IL-6, C-reactive protein, leukocyte subpopulations, and complications between the two groups. Stress response in single port laparoscopic cholecystectomy is equal to conventional surgery. Postoperative 4-hour VAS pain score was slightly worse and the operation time is significantly longer in the single port laparoscopic cholecystectomy group.

scholarly journals Impact of subclinical coronary artery disease on the clinical outcomes of carotid endarterectomy

2017 ◽  
Vol 126 (5) ◽  
pp. 1560-1565 ◽  
Author(s):  
Hyunwook Kwon ◽  
Dae Hyuk Moon ◽  
Youngjin Han ◽  
Jong-Young Lee ◽  
Sun U Kwon ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Primary Endpoint ◽  
Coronary Revascularization ◽  
Perioperative Period ◽  
Long Term Outcomes ◽  
Cardiac Damage ◽  
Artery Disease

OBJECTIVEControversy persists regarding the optimal management of subclinical coronary artery disease (CAD) prior to carotid endarterectomy (CEA) and the impact of CAD on clinical outcomes after CEA. This study aimed to evaluate the short-term surgical risks and long-term outcomes of patients with subclinical CAD who underwent CEA.METHODSThe authors performed a retrospective study of data from a prospective CEA registry. They analyzed a total of 702 cases involving patients without a history of CAD who received preoperative cardiac risk assessment by radionuclide myocardial perfusion imaging (MPI) and underwent CEA over a 10-year period. The management strategy (the necessity, sequence, and treatment modality of coronary revascularization and optimal perioperative medical treatment) was determined according to the presence, severity, and extent of CAD as determined by preoperative MPI and additional coronary computed tomography angiography and/or coronary angiography. Perioperative cardiac damage was defined on the basis of postoperative elevation of the blood level of cardiac troponin I (0.05–0.5 ng/ml) in the absence of myocardial ischemia. The primary endpoint was the composite of any stroke, myocardial infarction, or death during the perioperative period and all-cause mortality within 4 years of CEA. The associations between clinical outcomes after CEA and subclinical CAD were analyzed.RESULTSConcomitant subclinical CAD was observed in 81 patients (11.5%). These patients did have a higher incidence of perioperative cardiac damage (13.6% vs 0.5%, p < 0.01), but they had similar primary endpoint incidences during the perioperative period (2.5% vs.1.8%, p = 0.65) and similar estimated 4-year primary endpoint rates (13.6% vs 12.4%, p = 0.76) as the patients without subclinical CAD. Kaplan-Meier survival analysis showed that the 2 groups had similar rates of overall survival (p = 0.75).CONCLUSIONSPatients with subclinical CAD can undergo CEA with acceptable short- and long-term outcomes provided they receive selective coronary revascularization and optimal perioperative medical treatment.

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