Incidence of Postoperative Stroke Using the Heartstring Device in 1,380 Coronary Artery Bypass Graft Patients With Mild to Severe Atherosclerosis of the Ascending Aorta

2014 ◽  
Vol 97 (6) ◽  
pp. 2066-2072 ◽  
Author(s):  
Vinod H. Thourani ◽  
Seyed Amirhossein Razavi ◽  
Tom C. Nguyen ◽  
Patrick D. Kilgo ◽  
John D. Puskas ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Ascending Aorta ◽  
Artery Bypass Graft ◽  
Postoperative Stroke ◽  
Severe Atherosclerosis

scholarly journals Risks of Stroke After Coronary Artery Bypass Graft – Recent Insights and Perspectives

2011 ◽  
Vol 9 (2) ◽  
pp. 77 ◽  
Author(s):  
Tullio Palmerini ◽  
Carlo Savini ◽  
◽  
◽  
Keyword(s):  
Decision Making ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Ascending Aorta ◽  
Artery Bypass Graft ◽  
Permanent Disability ◽  
Increased Risk

Stroke is one of the most devastating complications after coronary artery bypass graft (CABG) surgery, entailing permanent disability, a 3–6 fold increased risk of mortality, an incremental hospital resource consumption and a longer length of hospital stay. Notwithstanding advances in surgical, anaesthetic and medical management across the last 10 years, the risk of stroke after CABG has not significantly declined, likely because an older and sicker population is now deemed suitable to undergo CABG. The pathogenesis of stroke is multifactorial, but two variables are believed to play a major role – cerebral embolisation of atheromatous debris arising from the ascending aorta during surgical manipulation and hypoperfusion during surgery. Identification of vulnerable patients at increased risk of stroke before CABG is of paramount importance for the surgical decision-making approach and informed consent. Several models including demographic, clinical and procedural variables have been developed to risk-stratify the hazard of stroke in patients undergoing CABG, but identification of severe atherosclerosis of the ascending aorta and pre-existing cerebrovascular disease are key determinants for appropriate risk stratification and decision-making. Atherosclerotic disease of the ascending aorta can be identified before surgery using transoesophageal echocardiography, computed tomography and magnetic resonance imaging. However, intra-operative ultrasound scanning of the ascending aorta is the diagnostic tool with the best sensitivity and specificity for the detection of atheromatous debris in the ascending aorta. Although many investigators have advocated the use of off-pump CABG to minimise the risk of peri-operative stroke, results from randomised trials and meta-analyses have been inconsistent. Anaortic approaches, including total arterial revascularisation within situgrafting of both mammary arteries, or the use of the HEARTSTRING® seal device avoid any manipulation of the aorta, thus potentially minimising the risk of stroke in high-risk patients. Assessment and treatment of severe carotid artery disease, and aggressive and prompt treatment of post-operative atrial fibrillation are other important strategies that should be routinely implemented to reduce the risk of stroke in patients undergoing CABG.

scholarly journals Reconstructing a Coronary Artery Bypass Graft of an Ascending Aorta after an Acute Type I Aortic Dissection

2007 ◽  
Vol 36 (4) ◽  
pp. 221-224 ◽  
Author(s):  
Ryota Asano ◽  
Kojiro Kodera ◽  
Yuji Suda ◽  
Akihito Sasaki ◽  
Masahiro Ikeda ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Ascending Aorta ◽  
Type I ◽  
Acute Type ◽  
Artery Bypass Graft

Statin in Combination With β-Blocker Therapy Reduces Postoperative Stroke After Coronary Artery Bypass Graft Surgery

2011 ◽  
Vol 91 (3) ◽  
pp. 654-659 ◽  
Author(s):  
Denis Bouchard ◽  
Michel Carrier ◽  
Philippe Demers ◽  
Raymond Cartier ◽  
Michel Pellerin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Blocker Therapy ◽  
Postoperative Stroke ◽  
Β Blocker

scholarly journals Influence of concomitant coronary artery bypass graft on outcome of surgery of the ascending aorta/arch

Heart ◽  
2005 ◽  
Vol 93 (2) ◽  
pp. 232-237 ◽  
Author(s):  
P Narayan ◽  
C A Rogers ◽  
M Caputo ◽  
G D Angelini ◽  
A J Bryan
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Ascending Aorta ◽  
Artery Bypass Graft ◽  
Outcome Of Surgery

scholarly journals Improve Morbidity and Mortality in Coronary Artery Bypass Graft Surgery for Severe Atherosclerosis

2011 ◽  
Vol 4 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Shinji Kanemitsu ◽  
Sawaka Tanabe ◽  
Kensuke Ohue ◽  
Hiroyuki Miyagawa ◽  
Yoichiro Miyake ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Morbidity And Mortality ◽  
Artery Bypass Graft ◽  
Severe Atherosclerosis
Sign in / Sign up

Export Citation Format

Share Document