Aortic assessment for cardiac surgical procedures.
Aortic atheromatous disease is associated with stroke in both the ambulatory and perioperative setting. In addition to atheromatous deposits, a reduction in the compliance of the aorta takes place as elastin fibers are replaced by collagen fibers. Both of these distinct processes, termed atherosclerosis, can easily be measured using transesophageal echocardiography during cardiac surgery. A review of the literature demonstrates many studies supporting the benefit of transesophageal echocardiography examination of the aorta for reducing stroke following cardiac surgery, through modification of surgical techniques. There have also been attempts by surgeons to remove atheromatous lesions from the aorta during cardiac surgery. Unfortunately, these procedures currently have a high perioperative mortality. Finally, medical therapy such as warfarin or statins may help reduce the incidence of stroke following heart surgery.
Bainbridge
Daniel
D
Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada. Daniel.Bainbridge@lhsc.on.ca
D000925:Anticoagulants / Q000627:therapeutic use; D001011:Aorta / Q000000981:diagnostic imaging* / Q000601:surgery; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D004691:Endarterectomy; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D014463:Ultrasonography; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin