| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2002;74:2097-2100
© 2002 The Society of Thoracic Surgeons
a Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, Fukuoka, Japan
Accepted for publication July 23, 2002.
* Address reprint requests to Dr Shimokawa, Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, 4-5 Sukukita, Kasuga City Fukuoka 816-0864, Japan.
e-mail: tshimokawa-circ{at}umin.ac.jp
BACKGROUND: Use of an aortic partial clamp for proximal anastomosis during off-pump coronary artery bypass is known to increase the risk of fatal complications. The purpose of this study was to assess the management of the ascending aorta evaluated with epiaortic ultrasonography during off-pump coronary artery bypass.
METHODS: Intraoperative ultrasonography of the ascending aorta with a 10-MHz probe was performed consecutively in 155 patients undergoing off-pump coronary artery bypass between August 1999 and July 2001. The findings from ultrasonography, surgical modifications, and operative results were analyzed.
RESULTS: In 54 patients (34.8%), epiaortic ultrasonography showed atherosclerotic findings in the anterior side of the ascending aorta (group A). The remaining 101 patients had either normal findings or atherosclerotic findings in only the posterior side (group NA). A proximal anastomosis to the aorta was preoperatively planned in 117 patients (group A, 42; group NA, 75). In group A, a graft modification without clamping was implemented in 29 patients (24.8% of 117 patients), whereas the clamp site was modified to a different segment in 13 patients (11.1% of 117 patients). In all 75 patients in group NA, partial clamping was used in the standard fashion. There were no cerebral infarctions or operative deaths related to partial clamping. However, aortic dissection occurred in 1 patient in group NA.
CONCLUSIONS: In 35% of patients undergoing off-pump coronary artery bypass, epiaortic ultrasonography identified atherosclerotic findings in the anterior wall of the ascending aorta. This study suggests that revascularization without aortic manipulation during off-pump coronary artery bypass is indicated in as many as 25% of patients.
This article has been cited by other articles:
|
|
 |
|
  T. Shimokawa, S. Manabe, T. Sawada, S. Matsuyama, T. Fukui, and S. Takanashi Intermediate-Term Patency of Saphenous Vein Graft With a Clampless Hand-Sewn Proximal Anastomosis Device After Off-pump Coronary Bypass Grafting Ann. Thorac. Surg., May 1, 2009; 87(5): 1416 - 1420. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y.- L. Li, D. T. Wong, W. Wei, and J. Liu A novel acoustic window for trans-oesophageal echocardiography by using a saline-filled endotracheal balloon Br. J. Anaesth., November 1, 2006; 97(5): 624 - 629. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Lev-Ran, R. Braunstein, R. Sharony, A. Kramer, Y. Paz, R. Mohr, and G. Uretzky No-touch aorta off-pump coronary surgery: The effect on stroke J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 307 - 313. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Das and J. Dunning Can epiaortic ultrasound reduce the incidence of intraoperative stroke during cardiac surgery? Interact CardioVasc Thorac Surg, March 1, 2004; 3(1): 71 - 75. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
