Increasing severity of aortic atherosclerosis in coronary artery bypass grafting patients evaluated by transesophageal echocardiography.
BACKGROUND
Atherosclerotic disease in coronary artery bypass grafting (CABG) patients is a potential contributor to complications in the perioperative periods. This study was undertaken to better define how the frequency of aortic atheromatous disease among patients coming for CABG has evolved over the last decade.


METHODS
Data from elective patients coming for CABG who underwent transesophageal echocardiography (TEE) examinations following induction of anesthesia were obtained for the years 2002 and 2009. Aortas were graded according to the method of Kronzon, with the following interpretations: normal = grade I, intimal thickening = 2, atheroma of less than 5 mm = 3, atheroma of > 5 mm = 4, and any mobile atheroma = 5. The data of 124 patients who underwent comprehensive exam of the aorta by one cardiac anesthesiologist were gathered and assigned into two groups based on the year TEE was done. Student's t-test was used for statistical analysis. A P value < 0.05 was considered significant. The data were presented as mean ± SD.


RESULTS
There was significant difference between group 2002 (2.05 ± 1.28) and group 2009 (2.59 ± 1.11) in atheroma grade (P = 0.013).


CONCLUSIONS
Patients coming for CABG in group 2009 exhibited significantly higher grades of aortic atheroma on TEE, compared to group 2002. Understanding the risk of atheroma in the elderly CABG population may help in altering surgical approaches to lessen the risk of catastrophic stroke. Potential options needing further study include the off-pump approach and modification of cross-clamp site and technique as well as other modalities.
Department of Anesthesia, Rutgers Robert Wood Johnson Medical School, Suite 3100 CAB, 125 Paterson Street, New Brunswick, NJ 08901, USA.
John T
JT
Denny
Department of Anesthesia, Rutgers Robert Wood Johnson Medical School, Suite 3100 CAB, 125 Paterson Street, New Brunswick, NJ 08901, USA.
Enrique
E
Pantin
Department of Anesthesia, Rutgers Robert Wood Johnson Medical School, Suite 3100 CAB, 125 Paterson Street, New Brunswick, NJ 08901, USA.
Antonio
A
Chiricolo
Department of Anesthesia, Rutgers Robert Wood Johnson Medical School, Suite 3100 CAB, 125 Paterson Street, New Brunswick, NJ 08901, USA.
James
J
Tse
Rutgers School of Nursing Graduate Program, 65 Bergen Street, Newark, NJ 07107, USA.
Julia E
JE
Denny
Department of Anesthesia, Rutgers Robert Wood Johnson Medical School, Suite 3100 CAB, 125 Paterson Street, New Brunswick, NJ 08901, USA.
Sagar S
SS
Mungekar
Department of Anesthesia, Rutgers Robert Wood Johnson Medical School, Suite 3100 CAB, 125 Paterson Street, New Brunswick, NJ 08901, USA.
Darrick
D
Chyu
Department of Anesthesia, Rutgers Robert Wood Johnson Medical School, Suite 3100 CAB, 125 Paterson Street, New Brunswick, NJ 08901, USA.
Alann
A
Solina
Aortic atherosclerosis; Aortic disease; Aortic plaque; Arteriosclerosis; Atheroma; Atherosclerosis; CABG surgery complications; Embolic sources