Department of Anesthesiology

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Aortic atheroma is related to outcome but not numbers of emboli during coronary bypass.

TitleAortic atheroma is related to outcome but not numbers of emboli during coronary bypass.
Publication TypeJournal Article
Year of Publication1997
AuthorsBarbut D, Lo YW, Hartman GS, Yao FS, Trifiletti RR, Hager DN, Hinton RB, Gold JP, Isom OW
JournalAnn Thorac Surg
Volume64
Issue2
Pagination454-9
Date Published1997 Aug
ISSN0003-4975
KeywordsAdult, Aged, Aged, 80 and over, Aortic Diseases, Arteriosclerosis, Coronary Artery Bypass, Echocardiography, Transesophageal, Female, Humans, Intracranial Embolism and Thrombosis, Length of Stay, Male, Middle Aged, Postoperative Complications, Ultrasonography, Doppler, Transcranial
Abstract

BACKGROUND: The relation between aortic atheroma severity and stroke after coronary artery bypass grafting is established. The relation between atheroma severity and other outcome measures or numbers of emboli has not been determined.

METHODS: Using transesophageal echocardiography, we determined the severity of atheroma in the ascending, arch, and descending aortic segments in 84 patients undergoing operations. Seventy patients were monitored using transcranial Doppler ultrasonography.

RESULTS: The incidence of stroke was 33.3% among 9 patients with mobile plaque of the arch and 2.7% among 74 patients with nonmobile plaque (p = 0.011). Cardiac complications were not significantly related to atheroma severity in any aortic segment. Length of stay was significantly related to atheroma severity in the aortic arch (p = 0.025) and descending segment (p = 0.024). The presence of severe atheroma in both the arch and descending segments was associated with significantly longer hospital stays as compared with patients with severe atheroma in neither segment (p = 0.05). Numbers of emboli were greater in patients with severe atheroma at clamp placement, although the differences did not achieve statistical significance.

CONCLUSIONS: Aortic atheroma severity is related to stroke and to the duration of hospitalization after coronary artery bypass grafting. The lack of correlation between numbers of emboli and atheroma severity suggests that m any emboli may be nonatheromatous in nature.

DOI10.1016/S0003-4975(97)00523-7
Alternate JournalAnn. Thorac. Surg.
PubMed ID9262593