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Management of a Patient with Atheromatous Aortic Arch Diagnosed by as Intraoperative Transesophageal Echocardiography during Coronary Artery Bypass Grafting
- Source :
- Korean Journal of Anesthesiology. 42:398
- Publication Year :
- 2002
- Publisher :
- The Korean Society of Anesthesiologists, 2002.
-
Abstract
- Protruding atheromas of the aorta have been identified as one of the sources of a systemic emboli and a major cause of stroke following cardiac surgery. We report a case of surgical modification in a 58-year-old man with an atheromatous aortic arch detected by an intraoperative transesophageal echocardiography (TEE) during coronary artery bypass grafting (CABG). After induction of anesthesia, protruding atheromatous plaques with a mobile element in the aortic arch were identified by a TEE that was not noticed by a preoperative angiography and transthoracic echocardiograpy. Based on the TEE finding, the surgical technique was modified to CABG combined with an aortic atherectomy under deep hypothermic circulatory arrest. The atheromatous areas correlated well with the TEE finding and the patient recovered from anesthesia and surgery without neurologic deficit. Therefore, an intraoperative TEE examination is considered as a safe and reliable technique to identify atherosclerotic disease of the thoracic aorta in patients undergoing CABG and to minimize unexpected neurologic complications after CABG.
- Subjects :
- Aortic arch
medicine.medical_specialty
Aorta
medicine.diagnostic_test
business.industry
medicine.medical_treatment
Surgery
Cardiac surgery
Atherectomy
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Internal medicine
medicine.artery
Angiography
cardiovascular system
medicine
Cardiology
Deep hypothermic circulatory arrest
Thoracic aorta
cardiovascular diseases
business
human activities
Artery
Subjects
Details
- ISSN :
- 03025780
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Korean Journal of Anesthesiology
- Accession number :
- edsair.doi...........c85c9721da141002dad0e0b65ca96be7