Aortic atherosclerosis and perioperative stroke in patients undergoing coronary artery bypass: role of intra-operative transesophageal echocardiography.
Intra-operative transesophageal echocardiography was performed in 126 patients undergoing coronary artery bypass grafting. Significant protruding atheromas (grade IV and V; Katz et al., 1992) were present in 12 patients (9.5%). Protruding atheromas had significantly higher incidence in patients above 60 years in age. Preoperative assessment with chest roentgenography and angiography, as well as intra-operative assessment by surgical palpation proved to be insensitive in detecting aortic atheromas. Out of four patients with grade V atheromas, two (50%) developed right hemiplegia postoperatively. For the rest, patients with grade V atheromas and eight patients with grade IV atheromas, surgical technique was modified and that helped in preventing occurrence of perioperative stroke.
Choudhary
S K
SK
Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Bhan
A
A
Sharma
R
R
Reddy
S C
SC
Airan
B
B
Narang
S
S
Venugopal
P
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction / Q000209:etiology* / Q000517:prevention & control; D001026:Coronary Artery Bypass; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control