HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kazuyuki Kuriu Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mizuno, T. Articles by Horimi, H. Search for Related Content PubMed PubMed Citation Articles by Mizuno, T. Articles by Horimi, H.

Ann Thorac Surg 2000;70:1565-1570
© 2000 The Society of Thoracic Surgeons

---

Original articles: cardiovascular

Thickened intima of the aortic arch is a risk factor for stroke with coronary artery bypass grafting

^a Department of Cardiovascular Surgery, Kameda Medical Center, Chiba, Japan
^b Department of Cardiovascular Surgery, Tokyo Takanawa Hospital, Tokyo, Japan

Address reprint requests to Dr Mizuno, Department of Cardiovascular Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa City, Chiba 296-8602, Japan

Background. Perioperative stroke is one of the most serious complications of cardiac surgery.

Methods. Using transesophageal echocardiography, we estimated the intimal thickness of the thoracic aorta as an index of the severity of aortic atherosclerosis to determine the risk of stroke in coronary artery bypass grafting (CABG) patients. The study population comprised 315 consecutive patients who underwent isolated CABG with cardiopulmonary bypass.

Results. Five patients (1.6%) had perioperative cerebral stroke or systemic emboli. We compared the mean intimal thicknesses of the ascending aorta, aortic arch, and descending aorta. Mean thicknesses in patients without stroke were 2.07 ± 0.76, 2.78 ± 1.15, and 2.32 ± 1.21 mm, respectively, and mean thicknesses in the stroke patients were 1.94 ± 0.55, 6.94 ± 3.79, and 3.39 ± 1.85 mm, respectively. The patients with an intima of more than 5 mm at the aortic arch had a significantly greater incidence of perioperative stroke (p = 0.007).

Conclusions. These results suggest that patients who have an aortic arch intima thickened to more than 5 mm are at a significantly high risk for perioperative stroke, and thus, the CABG procedure should be carefully evaluated to prevent such complications.

This article has been cited by other articles:

				K. G. Shann, D. S. Likosky, J. M. Murkin, R. A. Baker, Y. R. Baribeau, G. R. DeFoe, T. A. Dickinson, T. J. Gardner, H. P. Grocott, G. T. O'Connor, et al. An evidence-based review of the practice of cardiopulmonary bypass in adults: A focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 283 - 290.e3. [Full Text] [PDF]

				G. N. Djaiani Aortic arch atheroma: stroke reduction in cardiac surgical patients. Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2006; 10(2): 143 - 157. [Abstract] [PDF]

				K. Karkouti, G. Djaiani, M. A. Borger, W. S. Beattie, L. Fedorko, D. Wijeysundera, J. Ivanov, and J. Karski Low Hematocrit During Cardiopulmonary Bypass is Associated With Increased Risk of Perioperative Stroke in Cardiac Surgery Ann. Thorac. Surg., October 1, 2005; 80(4): 1381 - 1387. [Abstract] [Full Text] [PDF]

				T. Schachner, A. Zimmer, G. Nagele, G. Laufer, and J. Bonatti Risk factors for late stroke after coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 485 - 490. [Abstract] [Full Text] [PDF]

				R. C. Gilkeson, A. H. Markowitz, and L. Ciancibello Multisection CT Evaluation of the Reoperative Cardiac Surgery Patient RadioGraphics, October 1, 2003; 23(90001): S3 - 17. [Abstract] [Full Text] [PDF]

				J. M. Murkin Attenuation of neurologic injury during cardiac surgery Ann. Thorac. Surg., November 1, 2001; 72(5): S1838 - 1844. [Abstract] [Full Text] [PDF]