Aortic atheroma is related to outcome but not numbers of emboli during coronary bypass
| Autor: | Robert B. Hinton, Jeffrey P. Gold, Gregg S. Hartman, Rosario R. Trifiletti, O. Wayne Isom, F. S. Yao, David N. Hager, Yi Wen Lo, Denise Barbut |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Aortic arch medicine.medical_specialty Arteriosclerosis Ultrasonography Doppler Transcranial Aortic Diseases macromolecular substances Postoperative Complications medicine.artery Internal medicine medicine Humans cardiovascular diseases Derivation Coronary Artery Bypass Stroke Aged Aged 80 and over Aorta Aortic Segment business.industry Vascular disease Intracranial Embolism and Thrombosis Length of Stay Middle Aged medicine.disease Surgery body regions medicine.anatomical_structure Atheroma cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal Artery |
| Zdroj: | The Annals of Thoracic Surgery. 64:454-459 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(97)00523-7 |
| Popis: | 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 many emboli may be nonatheromatous in nature. |
| Databáze: | OpenAIRE |
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