Extracorporeal circulation before and after ultrasonographic evaluation of the ascending aorta.
BACKGROUND
To further gain insight into atheroembolization mechanisms epiaortic two-dimensional echocardiographic evaluation before extracorporeal circulation and after decannulation may be helpful.


METHODS
Epiaortic two-dimensional echocardiography was performed before cannulation and after decannulation in 188 (124 men) patients (mean age, 67.7 years; range, 43 to 86 years) undergoing operation with extracorporeal circulation for ischemic heart disease during 1996.


RESULTS
After decannulation, a new intimal lesion was recognized in 10 of 188 patients (5.3%): mobile type in 5 patients (3 ending with a stroke [60%], 2 having brain computed tomographic scans compatible with embolism), intimal tear in 2, and intimal irregularity in 3 patients. Stroke occurred in a significantly smaller number of patients (2 of 178 [1.1%]; p < 0.001) without new lesions.


CONCLUSIONS
Clamp- or cannula-induced new lesions, especially of mobile type, are often complicated by postoperative stroke. Aggressive surgical technique modifications may need to be considered to avoid creating new lesions, particularly of the mobile type.
Ura
M
M
Department of Cardiovascular Surgery, Kumamoto Central Hospital, Japan.
Sakata
R
R
Nakayama
Y
Y
Miyamoto
T A
TA
Goto
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control; D011300:Preoperative Care; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000293:injuries