Severity of aortic atheromatous disease diagnosed by transesophageal echocardiography predicts stroke and other outcomes associated with coronary artery surgery: A prospective study

Anesthesia and Analgesia

Volumn 83, Issue 4, 1996, Pages 701-708

  Hartman, Gregg S ^a,b   Yao, Fun Sun F ^a   Bruefach III, Mathias ^a   Barbut, Denise ^a   Peterson, Janey C ^a   Purcell, Mary Helen ^a   Charlson, Mary E ^a   Gold, Jeffrey P ^a   Thomas, Stephen J ^a   Szatrowski, Ted P ^a  

^a WEILL CORNELL MEDICAL COLLEGE   (United States)

^b WEILL CORNELL MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; AORTA ATHEROSCLEROSIS; ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CORONARY ARTERY BYPASS SURGERY; CORONARY ARTERY DISEASE; DISEASE SEVERITY; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; MEAN ARTERIAL PRESSURE; MORTALITY; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RISK FACTOR; STROKE; TRANSESOPHAGEAL ECHOCARDIOGRAPHY;

AGED; AORTA, THORACIC; AORTIC DISEASES; ARTERIOSCLEROSIS; BLOOD PRESSURE; CARDIOPULMONARY BYPASS; CEREBROVASCULAR DISORDERS; CORONARY ARTERY BYPASS; ECHOCARDIOGRAPHY, TRANSESOPHAGEAL; FEMALE; FOLLOW-UP STUDIES; FORECASTING; HUMANS; INTRAOPERATIVE CARE; MALE; MYOCARDIAL INFARCTION; POSTOPERATIVE COMPLICATIONS; PROSPECTIVE STUDIES; RISK FACTORS; SINGLE-BLIND METHOD; SURGICAL PROCEDURES, ELECTIVE; SURVIVAL RATE; TREATMENT OUTCOME;

EID: 10244254023     PISSN: 00032999     EISSN: None     Source Type: Journal    
DOI: 10.1097/00000539-199610000-00007     Document Type: Article

References (28)

1. CASS Principle Investigators and Their Associates. Myocardial infarction and mortality in the Coronary Artery Surgery Study (CASS) randomized trial. N Engl J Med 1984;310:750-8.
2. European Coronary Surgery Study Group. Long-term results of prospective randomized study of coronary artery bypass surgery in stable angina pectoris. Lancet 1982;2:1173-180.
3. Shaw PJ, Bates D, Cartlidge NEF, et al. Early neurological complications of coronary artery bypass surgery. BMJ 1985;291:1384-7.
4. Gardner TJ, Horneffer PJ, Manolio TA, et al. Stroke following coronary artery bypass grafting: a ten-year study. Ann Thorac Surg 1985;40:574-81.
5. Reed GL, Singer DE, Pilard EH. Stroke following coronary artery bypass surgery: a case-control estimate of the risks of carotid bruits. N Engl J Med 1988;319:1246-50.
6. Culliford AT, Colvin SB, Rohrer K, et al. The atherosclerotic ascending aorta and transverse arch: a new technique to prevent cerebral injury during bypass: experience with 13 patients. Ann Thorac Surg 1986;41:27-35.
7. Alfieri A, Kotler M. Noncardiac complications of open-heart surgery. Am Heart J 1990;119:149-58.
8. Wareing TH, Davila-Roman VG, Barzilai B, et al. Management of the severely atherosclerotic ascending aorta during cardiac operations: a strategy for detection and treatment. J Thorac Cardiovasc Surg 1992;103:453-62.
9. Marshall K, Kanchuger M, Kessler K, et al. Superiority of transesophageal echocardiography in detecting aortic arch atheromatous disease: identification of patients at increased risk of stroke during cardiac surgery. J Cardiothorac Vasc Anesth 1994;8:5-13.
10. Katz ES, Tunick PA, Rusinek H, et al. Protruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypass: experience with intraoperative transesophageal echocardiography. J Am Coll Cardiol 1992;20:70-7.
11. Gold JP, Charlson ME, Williams-Russo P, et al. Improvement of outcomes after coronary artery bypass: a randomized trial comparing intraoperative high vs low mean arterial pressure. J Thorac Cardiovasc Surg 1995;110:1302-14.
12. Charlson M, Akels K, Pompei P, MacKenzie C. A new method of classification of prognostic comorbidity for longitudinal studies: development and validation. J Chron Dis 1987;40:373-83.
13. Hartman GS, Peterson J, Konstadt SN, et al. High reproducibility in the interpretation of intraoperative transesophageal echocardiographic evaluation of aortic atheromatous disease. Anesth Analg 1996;82:539-43.
14. SAS. SAS/STAT user's guide, version 6, chapter 27, the logistic procedure. 1989;2:1071-126.
15. Nussmeier NA. Neuropsychiatric complications of cardiac surgery. J Cardiothorac Vasc Anesth 1994;8:13-8.
16. Taylor K. Pathophysiology of brain damage during open heart surgery. Tex Heart Inst J 1986;13:91-6.
17. Rafferty TD, Lippmann H. Intraoperative two-dimensional echocardiography and color-flow Doppler imaging: a basic transesophageal single plane patient examination. Yale J Biol Med 1994;66:349-83.
18. Konstadt SN, Reich DL, Kahn R, Viggianti R. Transesophageal echocardiography can be used to screen for ascending aortic atherosclerosis. Anesth Analg 1995;81:225-8.
19. Blanchard DG, Kimura BJ, Dittrich HC, DeMaria AN. Transesophageal echocardiography of the aorta. JAMA 1994;272:546-51.
20. Konstadt SN, Reich DL, Quintana C, Levy M. The ascending aorta: how much does transesophageal echocardiography see? Anesth Analg 1994;78:240-4.
21. Hartman GS, Bruefach M, Yao FS, et al. Relationship between TEE assessed atheromatous disease of the descending aorta and stroke in CABG patients [abstract]. Anesthesiology 1994;81:A109.
22. Guzzetta NA, Lee E, Sadel SM, et al. Does the degree of atheromatous disease in the descending thoracic aorta correlate with atheromatous disease in the ascending aorta? [abstract]. Anesth Analg 1995;80(Suppl):SCA95.
23. Kanchuger M, Marshall K, Tissot M, et al. Epiaortic ultrasonography is superior to biplane transesophageal echocardiography or surgical palpation in detecting ascending aortic atherosclerosis [abstract]. Anesthesiology 1994;81:A110.
24. Savage E, Cohn L. "No touch" dissection, antegrade-retrograde blood cardioplegia, and single aortic cross-clamp significantly reduce operative mortality of reoperative CABG. Circulation 1994;90:140-3.
25. Kouchoukos NT. Adjuncts to reduce the incidence of embolic brain injury during operations on the aortic arch. Ann Thorac Surg 1994;57:243-5.
26. Slogoff S, Reul GJ, Keats AS. Role of perfusion pressure and flow in major organ dysfunction after cardiopulmonary bypass. Ann Thorac Surg 1990;50:911-8.
27. Akins CW. Noncardioplegic myocardial preservation for coronary revascularization. J Thorac Cardiovasc Surg 1986;88:174-81.
28. Charlson ME, MacKenzie CR, Gold JP, et al. Pre-operative and intra-operative hemodynamic predictors of post-operative myocardial infarction or ischemia in patients undergoing non-cardiac surgery. Ann Surg 1989;210:637-48.