Carotid and aortic screening for coronary artery bypass grafting.
BACKGROUND
To identify risk factors for preexisting carotid and aortic disease in coronary artery bypass grafting (CABG), preoperative parameters were analyzed.


METHODS
Three-hundred eight consecutive patients undergoing elective isolated CABG were investigated through preoperative duplex scanning of the carotid artery, computed tomography of the chest, and intraoperative ultrasonography of the ascending aorta.


RESULTS
Prevalence of carotid stenosis and ascending aortic atherosclerosis was 14.3% (44 of 308) and 30.2% (93 of 308), respectively. Multivariate analysis indicated that significant independent risk factors for carotid stenosis were atherosclerosis of the ascending aorta (p = 0.028, odds ratio [OR] = 2.16), peripheral vascular disease (p = 0.008, OR = 4.08), and history of stroke (p = 0.0004, OR = 3.73). Significant independent risk factors for ascending aortic atherosclerosis were peripheral vascular disease (p = 0.029, OR = 3.05), age older than 60 years (p = 0.009, OR = 2.94), and carotid stenosis (p = 0.018, OR = 2.27). Modifications on the operative procedure for aortic atherosclerosis were carried out in 49 patients. Overall hospital mortality and morbidity for stroke were 0.97% and 0.65%, respectively.


CONCLUSIONS
Prevalence of carotid and aortic disease was not low among candidates for CABG. Carotid and aortic screening may help to modify the operative strategy to reduce morbidity of stroke.
Fukuda
I
I
Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Ibaraki, Japan. fukuda@tmch.or.jp
Gomi
S
S
Watanabe
K
K
Seita
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta; D001018:Aortic Diseases / Q000175:diagnosis*; D001161:Arteriosclerosis / Q000175:diagnosis*; D016893:Carotid Stenosis / Q000175:diagnosis*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged