Our Summary

This research looked at the use of a type of ultrasound test (duplex carotid artery screening) in patients about to undergo heart bypass surgery. The study was done in Saudi Arabia from 2015 to 2018 and involved 178 Saudi patients. The test was used to estimate the severity of narrowing (stenosis) in the carotid artery, a major blood vessel in the neck that supplies blood to the brain. The study found that 72% of the patients had some degree of carotid artery disease, while 6.2% had severe narrowing of the artery. After the bypass surgery, 4.5% of the patients had a neurological event, such as a mini-stroke or stroke. The study found that older patients, those with severe carotid artery narrowing, and those with disease in multiple heart vessels were more likely to have a neurological event after bypass surgery. The researchers concluded that the ultrasound test might be useful in predicting which patients are at a higher risk of having a stroke after heart bypass surgery.

FAQs

  1. What is the purpose of the duplex carotid artery screening before heart bypass surgery?
  2. What percentage of patients in the study had some degree of carotid artery disease?
  3. Can the ultrasound test predict which patients are at a higher risk of having a stroke after heart bypass surgery?

Doctor’s Tip

A helpful tip a doctor might give a patient about CABG (coronary artery bypass grafting) is to discuss with your healthcare provider the possibility of having a duplex carotid artery screening before the surgery. This test can help assess the severity of narrowing in the carotid artery and identify patients who may be at higher risk for neurological events, such as strokes, after the procedure. By having this information, your healthcare team can take appropriate measures to reduce your risk and provide optimal care during and after the surgery.

Suitable For

Patients who are typically recommended for coronary artery bypass grafting (CABG) include those with severe coronary artery disease, significant blockages in multiple coronary arteries, and those who have not responded well to other treatments such as medication or lifestyle changes. Additionally, patients who are at high risk for a heart attack or other serious cardiovascular events may also be recommended for CABG. Other factors that may influence the recommendation for CABG include the patient’s overall health, age, and presence of other medical conditions such as diabetes or kidney disease.

Timeline

Before CABG:

  • Patient undergoes tests and evaluations to determine the need for CABG, including physical exams, blood tests, ECG, stress tests, and imaging tests.
  • Patient may be prescribed medications to manage symptoms and improve heart function.
  • Patient may undergo cardiac rehabilitation to improve overall health and prepare for surgery.

After CABG:

  • Patient is monitored closely in the intensive care unit immediately after surgery.
  • Patient may experience pain, discomfort, and fatigue in the days following surgery.
  • Patient undergoes physical therapy to regain strength and mobility.
  • Patient is prescribed medications to prevent blood clots, manage pain, and control blood pressure.
  • Patient attends follow-up appointments to monitor progress and make necessary lifestyle changes to prevent future heart problems.

What to Ask Your Doctor

  1. What is the purpose of the duplex carotid artery screening test in relation to my upcoming CABG surgery?
  2. How accurate is this test in determining the severity of narrowing in my carotid artery?
  3. What are the potential risks or complications associated with severe carotid artery disease in relation to my surgery?
  4. Based on the results of this test, am I considered to be at a higher risk for a neurological event after my bypass surgery?
  5. What steps can be taken to minimize the risk of a stroke or mini-stroke during or after my CABG surgery?
  6. Are there any additional tests or procedures that should be considered based on the findings of the duplex carotid artery screening?
  7. How will the results of this test affect the overall management of my heart disease and treatment plan for my CABG surgery?
  8. Are there any lifestyle changes or medications that I should consider to reduce my risk of a stroke after my bypass surgery?
  9. How often should I have follow-up assessments or monitoring of my carotid artery health after my CABG surgery?
  10. Are there any specific warning signs or symptoms that I should be aware of in relation to my carotid artery health post-surgery?

Reference

Authors: Waheed KB, Alzahrani FM, Sharif MN, Al Jubair NN, Hundallah MJ, Amin MS, Arulanantham ZJ. Journal: Neurosciences (Riyadh). 2019 Apr;24(2):122-129. doi: 10.17712/nsj.2019.2.20180022. PMID: 31056544