Introduction
Surgical management of coexisting cardiac disease and extra-cranial
carotid artery disease is a controversial area of debate, especially
when carotid lesion is asymptomatic.1,2 Meta-analyses
reported contradictory results, adequately powered randomized clinical
trials do not exist demonstrating the superiority of one treatment
strategy over another, and clinical practice guidelines from
professional cardiovascular societies have not recommended or precluded
the adoption of a specific strategy.3-10 Currently,
the timing of the intervention primarily depends on clinical
presentation and institutional experience.11 Thus, in
this challenging scenario, risk stratification may play a key role in
surgical decision making. Utilization of a risk index model when
approaching patient selection and treatment modality recommendations
could give physicians a more accurate way of predicting postoperative
outcomes by and providing them with additional information with
high-risk patients.12 While most of the single-center
experiences focused on overall stroke and mortality risk analysis, there
are no specific data reporting on specific predictors for these major
outcomes.
The aim of this study was to identify predictors for 30-day mortality,
on a cohort of consecutive patients treated with single stage
coronary/valve surgery (CVS) and carotid endarterectomy (CEA).