title: Aortic atheroma is related to outcome but not numbers of emboli during coronary bypass.
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.
authors.affiliation: Department of Neurology, Cornell University Medical College, New York, New York, USA.
authors.forename: D
authors.initials: D
authors.lastname: Barbut
authors.forename: Y W
authors.initials: YW
authors.lastname: Lo
authors.forename: G S
authors.initials: GS
authors.lastname: Hartman
authors.forename: F S
authors.initials: FS
authors.lastname: Yao
authors.forename: R R
authors.initials: RR
authors.lastname: Trifiletti
authors.forename: D N
authors.initials: DN
authors.lastname: Hager
authors.forename: R B
authors.initials: RB
authors.lastname: Hinton
authors.forename: J P
authors.initials: JP
authors.lastname: Gold
authors.forename: O W
authors.initials: OW
authors.lastname: Isom
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D001161:Arteriosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D017585:Ultrasonography, Doppler, Transcranial