Methods of evaluation of brain functional reserve for selection of surgical tactics in patients with atherosclerotic lesions in both coronary and carotid arteries

The study provided a comparative analysis of occurrence rates of neurological and cardiac complications in the early postoperative period in 68 patients with combined atherosclerotic lesions in carotid and coronary arteries. Among the entire patient sample, 28 patients underwent simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA) whereas 40 patients received twostage surgical treatment where CEA was followed by CABG. Data of the study showed that the functional evaluation of cardiac and cerebral perfusion reserve allowed to identify high risk patients with atherosclerotic lesions in both coronary and carotid arterial beds. The approach contributed to the optimal choice of surgical treatment modality. As a result of the study, we proposed the algorithm of surgical tactics based on determination of functional cardiac and cerebral perfusion reserve.