3197 consecutive adult patients underwent major cardiac surgery in our center between January 2002 and December 2012. 3150 of these had preoperative duplex scanning, and out of these, 210 patients (6.6%) had significant carotid artery disease defined as 猢?5% stenosis (Group A), while 2940 (94.4%) were free from carotid artery disease (Group B). Both groups were compared for presence of pre-operative risk factors and for occurrence of adverse events in the immediate post-operative period.
In uni-variant analysis, pre-operative risk factors for the presence of carotid artery stenosis were diabetes mellitus (p < 0.0001); hypertension (p < 0.0001); past cerebrovascular accident (p < 0.0001) and peripheral vascular disease (p < 0.0001). All-cause in hospital mortality was high in group A in comparison to group B (3.8% vs 1.56%; p = 0.004). The Morbidity was also high in group A compared to group B in terms of stroke (4.3% vs 1.6%; p = 0.0014), nosocomial pneumonia (16.4% vs 8.9%; p = 0.0015), leg wound infection (14.2% vs 6%; p = 0.0001), septicemia (9.3% vs 4.8%; p = 0.013), acute limb ischemia (1.1% vs 0.4%; p = 0.034), new-onset atrial fibrillation (26.8% vs 16.3%; p = 0.0005), ventricular fibrillation (4.9% vs 1.5%; p = 0.0035) and renal dysfunction (11% vs 4.9%; p = 0.0017).
The Presence of carotid artery disease in Saudi patients undergoing cardiac surgery is associated with increased prevalence of diabetes, hypertension, cerebro-vascular accidents and peripheral vascular disease. It is also a major determinant of adverse outcome after coronary surgery.