TITLE

The impact of asymptomatic carotid artery disease on the intraoperative course of coronary artery bypass surgery

AUTHOR(S)
Dworschak, Martin; Czerny, Martin; Grimm, Michael; Grubhofer, Georg; Plöchl, Walter
PUB. DATE
January 2003
SOURCE
Perfusion;Jan2003, Vol. 18 Issue 1, p15
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Asymptomatic carotid artery stenosis (CAS) may result in neurological injury after coronary artery bypass surgery, but routine preoperative carotid screening is not undisputed. We studied whether routinely determined carotid duplex results, beyond detecting high-risk patients, additionally influence intraoperative course. One hundred and eight patients without new signs of impaired cerebral circulation were investigated. Anesthesiology, perfusionist records, and patient files were reviewed for patient characteristics, intraoperative variables and postoperative neurological sequelae. There was a higher incidence of prior cerebrovascular events and peripheral artery disease in CAS patients (p < 0.05). Pulsatile flow was employed more frequently in this group (p < 0.05). Severe hyperventilation, hyperglycemia, hemodilution, hyperthermia, and lactacidosis were avoided in both groups. However, labile hemodynamics of CAS patients required more corrective interventions (p < 0.05). There was also a tendency toward greater mortality. Stroke and transient ischemic attack (TIA) occurred in two patients without CAS. Since CAS was associated with a greater degree of cardiovascular instability requiring frequent measures to control hemodynamics, positive duplex results should heighten vigilance. Although CAS does not appear to be the major source of cerebral ischemia, it involves significant comorbidity.
ACCESSION #
9459292

 

Related Articles

  • Correspondence. del Campo, Carlos; Zelman, Robert // Canadian Journal of Surgery;Aug2001, Vol. 44 Issue 4, p305 

    Examines the occurrence of anastomotic stenosis after minimally invasive direct coronary artery bypass. Diagnosis of the case; Treatment of the case; Factors contributing to the development of the symptoms.

  • Reversible anastomotic stenosis after minimally invasive coronary artery bypass grafting. Morin, Jean-Francois // Canadian Journal of Surgery;Feb2001, Vol. 44 Issue 1, p59 

    Reports the reversible anastomotic stenosis after minimally invasive coronary artery bypass grafting. Demonstration of the collateral flow by the lack of hemodynamic compromise; Advantages of intraoperative angiography; Assessment of the patency of the anastomosis.

  • Stenting versus minimally invasive bypass. Pinkowish, Mary Desmond // Patient Care;Oct2002, Vol. 36 Issue 12, p100 

    Discusses research being done on the comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery. Reference to a study by A. Diegeler et al published in the 2002 issue of the "New England Journal of Medicine"; Methodology of the...

  • Novel percutaneous closure of a left coronary artery aneurysm. Egred, M.; Hussey, J. K.; Metcalfe, M. J. // Heart;Oct2001, Vol. 86 Issue 4, p455 

    A 66 year old man with two previous coronary bypass surgeries underwent coronary angiography and grafts restudy for recurrent angina. A vein graft to the left anterior descending artery (LAD) severe stenosis before its insertion with an aneurysmal dilatation of the LAD at the site of the graft...

  • Long term follow up after elective percutaneous coronary intervention for unprotected non-bifurcational left main stenosis: is it time to change the guidelines? Brueren B R G; Ernst J M P G; Suttorp M J; ten Berg J M; Rensing B J W M; Mast E G; Bal E T; Six A J; Plokker H W M; Brueren, B R G; Ernst, J M P G; Suttorp, M J; ten Berg, J M; Rensing, B J W M; Mast, E G; Bal, E T; Six, A J; Plokker, H W M // Heart;Nov2003, Vol. 89 Issue 11, p1336 

    Background: According to the American College of Cardiology/American Heart Association guidelines, percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) stenosis is contraindicated and coronary artery bypass graft surgery (CABG) is preferred. However, PCI of...

  • Recent Gross Intramural Plaque Hemorrhage in Asymptomatic High-Grade Carotid Stenosis. Archie Jr., Joseph P. // Vascular Surgery;Sep/Oct1989, Vol. 23 Issue 5, p355 

    The plaques of 124 consecutive primary carotid endarterectomies in 111 patients performed for asymptomatic 75% or greater diameter internal carotid stenosis were examined for gross intramural plaque hemorrhage. There were 74 endarterectomies in 61 asymptomatic patients (13 bilateral). Nineteen...

  • CABG complication: Subclavian artery steal syndrome increases risk of ischemia, death. Eugene, Jean-Renoir; Barnes, Thomas; Tagoe, Albert; Miglietta, Maurizio; Edwards, Joseph; Schwartz, Kenneth; Nwiloh, Jonathon O.; Asche-Crowe, Pearl // Geriatrics;Sep2001, Vol. 56 Issue 9, p49 

    Presents information on a study which examined the incidence of subclavian artery steal syndrome associated with coronary artery bypass graft that employs left internal mammary artery as a bypass graft. Signs and symptoms of the syndrome; Epidemiology and representation of subclavian stenosis;...

  • 19-Year Patency of a Coronary-Coronary Venous Bypass Graft. Mariscalco, Giovanni; Blanzola, Claudio; Leva, Cristian; Bruno, Vito D.; Luvini, Marcella; Sala, Andrea // Texas Heart Institute Journal;2005, Vol. 32 Issue 4, p583 

    No data are available on the long-term outcome of coronary--coronary venous bypass grafting. We describe a case in which we successfully stented a discrete, critical stenosis of a coronary--coronary venous graft that had been placed 19 years earlier to minimize manipulation of a severely...

  • Takayasu's Arteritis. Kumar, G. Venkata Ramana; Agarwal, N. B.; Javali, Satish; Patwardhan, Anil Madhav // Texas Heart Institute Journal;2007, Vol. 34 Issue 4, p470 

    Takayasu's arteritis with coronary artery involvement is rare, and there is little published information on the subject. Coronary angiographic and histopathologic studies have revealed coronary artery lesions in 9% to 11% of cases. Coronary artery involvement consists mostly of stenosis or...

Share

Read the Article

Courtesy of NEW JERSEY STATE LIBRARY

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics