title: Aortic atherosclerosis and perioperative stroke in patients undergoing coronary artery bypass: role of intra-operative transesophageal echocardiography.
abstract: 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.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Choudhary
authors.forename: A
authors.initials: A
authors.lastname: Bhan
authors.forename: R
authors.initials: R
authors.lastname: Sharma
authors.forename: S C
authors.initials: SC
authors.lastname: Reddy
authors.forename: B
authors.initials: B
authors.lastname: Airan
authors.forename: S
authors.initials: S
authors.lastname: Narang
authors.forename: P
authors.initials: P
authors.lastname: Venugopal
mesh_terms: 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