title: Complete thromboendarterectomy of the calcified ascending aorta and aortic arch.
abstract: BACKGROUND
  Arteriosclerotic plaques of the ascending aorta and transverse arch increase the operative risk of cardiac operations and are strong predictors for late cerebrovascular events.
  
  
  METHODS
  Twenty-two patients, mean age 68 +/- 6 years (range, 55 to 77 years), with grade IV + V plaques of the ascending aorta and transverse arch underwent coronary artery bypass grafting (n = 21) and aortic valve replacement (n = 8). Cerebrovascular emboli from unknown sources were found preoperatively in 8 patients (36%). All were in sinus rhythm. Complete thromboendarterectomy of the ascending aorta and transverse arch was performed during hypothermic circulatory arrest. After 21 +/- 12 months (range, 4 to 44 months), magnetic resonance imaging and transthoracic echocardiography of endarterectomized vessels was performed.
  
  
  RESULTS
  There was one perioperative death (4.5%), one early (4.5%), and one late (4.7%) adverse neurologic event. Follow-up examinations revealed normal diameters of the endarterectomized aorta.
  
  
  CONCLUSIONS
  For patients with grade IV + V plaques, thromboendarterectomy of the ascending aorta and transverse arch can be performed with an acceptable surgical risk and a low recurrence rate for cerebrovascular events. Dilatation of the endarterectomized aorta was not observed.
authors: Clinic for Cardiovascular Surgery, Institute for Diagnostic Radiology, Department of Neurology, University Hospital, Zurich, Switzerland.
authors: P R
authors: PR
authors: Vogt
authors: M
authors: M
authors: Hauser
authors: U
authors: U
authors: Schwarz
authors: R
authors: R
authors: Jenni
authors: M L
authors: ML
authors: Lachat
authors: G
authors: G
authors: Zünd
authors: R W
authors: RW
authors: Schüpbach
authors: D
authors: D
authors: Schmidlin
authors: M I
authors: MI
authors: Turina
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology / Q000601:surgery; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery; D001161:Arteriosclerosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D001026:Coronary Artery Bypass; D004691:Endarterectomy / Q000295:instrumentation*; D005260:Female; D006324:Heart Arrest, Induced; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality