Diagnosis and management of severe atherosclerosis of the ascending aorta and aortic arch during cardiac surgery: focus on aortic replacement

European Journal of Cardio-thoracic Surgery

Volumn 31, Issue 6, 2007, Pages 990-997

  Zingone, Bartolo ^a   Rauber, Elisabetta ^a   Gatti, Giuseppe ^a   Pappalardo, Aniello ^a   Benussi, Bernardo ^a   Forti, Gabriella ^a   Tognolli, Umberto ^a   Gabrielli, Marco ^a  

^a UNIVERSITY HOSPITAL OF TRIESTE   (Italy)

Author keywords

Aorta; Aortic atherosclerosis; Perioperative; Porcelain aorta; Stroke

Indexed keywords

ADULT; AGED; AORTA ARCH; AORTA ATHEROSCLEROSIS; AORTA SURGERY; AORTA VALVE REPLACEMENT; ARTICLE; ASCENDING AORTA; COGNITIVE DEFECT; CONTROLLED STUDY; CORONARY ARTERY BYPASS GRAFT; CRYOABLATION; DIAGNOSTIC PROCEDURE; DISEASE SEVERITY; EMERGENCY SURGERY; FEMALE; HEART ARREST; HEART ATRIUM FIBRILLATION; HEART INFARCTION; HEART MUSCLE REVASCULARIZATION; HEART SURGERY; HUMAN; MAJOR CLINICAL STUDY; MALE; PEROPERATIVE COMPLICATION; PRIORITY JOURNAL; STROKE; SURGICAL MORTALITY;

AGED; AGED, 80 AND OVER; AORTA; AORTA, THORACIC; AORTIC DISEASES; ATHEROSCLEROSIS; BLOOD VESSEL PROSTHESIS IMPLANTATION; CARDIAC SURGICAL PROCEDURES; CORONARY ARTERY BYPASS; FEMALE; HUMANS; KAPLAN-MEIERS ESTIMATE; MALE; MIDDLE AGED; POSTOPERATIVE COMPLICATIONS; REOPERATION; TIME FACTORS; TREATMENT OUTCOME;

EID: 34248161949     PISSN: 10107940     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ejcts.2007.02.017     Document Type: Article

References (25)

1. Mills N.L., and Everson C.T. Atherosclerosis of the ascending aorta and coronary artery bypass. Pathology, clinical correlates and operative management. J Thorac Cardiovasc Surg 102 (1991) 546-553
2. Blauth C.I., Cosgrove D.M., Webb B.W., Ratliff N.B., Boylan M., Piedmonte M.R., Lytle B.W., and Loop F.D. Atheroembolism from the ascending aorta. An emerging problem in cardiac surgery. J Thorac Cardiovasc Surg 103 (1992) 1104-1112
3. Roach G.W., Kanchuger M., Mangano C.N., Newman M., Nussmeier N., Wolman R., Aggarwal A., Marschall K., Graham S.H., Ley C., Ozanne G., and Mangano D.T. Adverse cerebral outcomes after coronary bypass surgery. N Eng J Med 335 (1996) 1857-1863
4. Djaiani G., Fedorko L., Borger M., Mikulis D., Carroll J., Cheng D., Karkouti K., Beattie S., and Karski J. Mild to moderate atheromatous disease of the thoracic aorta and new ischemic brain lesions after conventional coronary artery bypass graft surgery. Stroke 35 (2004) e356-e358
5. Sharony R., Grossi E.A., Saunders P.C., Galloway A.C., Applebaum R., Ribakove C.H., Culliford A.T., Kanchuger M., Kronzon I., and Colvin S.B. Propensity case-matched analysis of off-pump coronary artery bypass grafting in patients with atheromatous aortic disease. J Thorac Cardiovasc Surg 127 (2004) 406-413
6. Wareing T.H., Davila-Roman V.G., Daily B.B., Murphy S.F., Schechtman K.B., Barzilai B., and Kouchoukos N.T. Strategy for the reduction of stroke incidence in cardiac surgical patients. Ann Thorac Surg 55 (1993) 1400-1408
7. van der Linden J., Hadjinikolaou L., Bergman P., and Lindblom D. Postoperative stroke in cardiac surgery is related to the location and extent of atherosclerotic disease in the ascending aorta. J Am Coll Cardiol 38 (2001) 131-135
8. Gillinov A.M., Lytle B.W., Hoang V., Cosgrove D.M., Banbury M.K., McCarthy P.M., Sabik J.F., Petterson G.B., Smedira N.G., and Blackstone E.H. The atherosclerotic aorta at aortic valve replacement: surgical strategies. J Thorac Cardiovasc Surg 120 (2000) 957-965
9. Aranki S.F., Nathan M., Shekar P., Couper G., Rizzo R., and Cohn L.H. Hypothermic circulatory arrest enable aortic valve replacement in patients with unclampable aorta. Ann Thorac Surg 80 (2005) 1679-1687
10. Vogt P.R., Hauser M., Schwarz U., Jenni R., Lachat M.L., Zünd G., Schüpbach R.W., Schmidlin D., and Turina M.I. Complete thromboendarterectomy of the calcified ascending aorta and aortic arch. Ann Thorac Surg 67 (1999) 457-461
11. Zingone B., Rauber E., Gatti G., Pappalardo A., Benussi B., Dreas L., and Lattuada L. The impact of epiaortic ultrasonographic scanning on the risk of perioperative stroke. Eur J Cardio-Thorac Surg 29 (2006) 720-728
12. Stern A., Tunick P.A., Culliford A.T., Lachmann J., Baumann F.G., Kanchuger M.S., Marschall K., Shah A., Grossi E., and Kronzon I. Protruding aortic arch atheromas: risk of stroke during heart surgery with and without aortic arch endarterectomy. Am Heart J 138 (1999) 746-752
13. Wolman R., Nussmeier N., Aggarwal A., Kanchuger M., Roach G.W., Newman M.F., Mangano C.N., Marschall K., Ley C., Boisvert D.M., Ozanne G., Herskowitz A., Graham S.H., and Mangano D.T. Cerebral injury after cardiac surgery. Identification of a group at extraordinary risk. Stroke 30 (1999) 514-522
14. Bucerius J., Gummert J.F., Borger M.A., Walther T., Doll N., Onnasch J.F., Metz S., Falk V., and Mohr F.W. Stroke after cardiac surgery: a risk factor analysis of 16,184 consecutive adult patients. Ann Thorac Surg 75 (2003) 472-478
15. Floyd T.F., Shah P.N., Price C.C., Harris F., Ratcliffe S.J., Acker M.A., Bavaria J.E., Rahmouni H., Kuersten B., Wiegers S., McGarvey M.L., Woo J.Y., Pochettino A.A., and Melhem E.R. Clinically silent cerebral ischemic events after cardiac surgery: their incidence, regional vascular occurrence, and procedural dependence. Ann Thorac Surg 81 (2006) 2160-2166
16. Zingone B., Gatti G., Rauber E., Pappalardo A., Benussi B., and Dreas L. Surgical management of the atherosclerotic ascending aorta. Is endoaortic balloon occlusion safe?. Ann Thorac Surg 82 (2006) 1709-1714
17. Jacobowitz I.J., Rose D.M., Shevede K., and Cunningham Jr. J.N. Use of profound hypothermia and circulatory arrest for the calcified aorta. Chest 85 (1984) 288-289
18. Coselli J.S., and Crawford E.S. Aortic valve replacement in the patient with extensive calcification of the ascending aorta (the porcelain aorta). J Thorac Cardiovasc Surg 91 (1986) 184-187
19. Byrne J.G., Aranki S.F., and Cohn L.H. Aortic valve operations under deep hypothermic circulatory arrest for the porcelain aorta: 'no-touch' technique. Ann Thorac Surg 65 (1998) 1313-1315
20. Culliford A.T., Colvin S.B., Rohrer K., Baumann F.G., and Spencer F.C. The atherosclerotic ascending aorta and transverse arch: a new technique to prevent cerebral injury during bypass: experience with 13 patients. Ann Thorac Surg 41 (1986) 27-34
21. Svensson L.G., Sun J., Cruz H.A., and Shahian D.M. Endarterectomy for calcified porcelain aorta associated with aortic valve stenosis. Ann Thorac Surg 61 (1996) 149-152
22. King R.C., Kanithanon C., Shockey K.S., Spotnitz W.D., Tribble C.G., and Kron I.L. Replacing the atherosclerotic ascending aorta is a high-risk procedure. Ann Thorac Surg 66 (1998) 396-401
23. Girardi L.N., Krieger K.H., Mack C.A., and Isom O.W. No-clamp technique for valve repair or replacement in patients with a porcelain aorta. Ann Thorac Surg 80 (2005) 1688-1692
24. Kouchoukos NT, in discussion of: Gillinov AM, Lytle BW, Hoang V, Cosgrove DM, Banbury MK, McCarthy PM, Sabik JF, Petterson GB, Smedira NG, Blackstone EH. The atherosclerotic aorta at aortic valve replacement: surgical strategies. J Thorac Cardiovasc Surg 2000; 120:95-65.
25. Svensson L.G., Blackstone E.H., Rajeswaran J., Sabik III J.F., Lytle B.W., Gonzalez-Stawinski G., Varvitsiotis P., Banbury M.K., McCarthy P.M., Petterson G.B., and Cosgrove D.M. Does the arterial cannulation site for circulatory arrest influence stroke risk?. Ann Thorac Surg 78 (2004) 1274-1284