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Published on: May 15, 2020

Thickened intima of the aortic arch is a risk factor for stroke with coronary artery bypass grafting

T Mizuno1, M Toyama, N Tabuchi

  • 1Department of Cardiovascular Surgery, Kameda Medical Center, Kamogawa City, Chiba, Japan.

The Annals of Thoracic Surgery
|November 28, 2000
PubMed

Insights

Aortic arch intima thickness exceeding 5 mm significantly increases stroke risk in coronary artery bypass grafting (CABG) patients. Careful evaluation is crucial for preventing perioperative stroke complications.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Vascular Medicine

Background:

  • Perioperative stroke is a critical complication following cardiac surgery.
  • Aortic atherosclerosis severity is linked to stroke risk in these patients.

Purpose of the Study:

  • To assess the correlation between thoracic aortic intimal thickness and stroke risk in coronary artery bypass grafting (CABG) patients.
  • To identify intimal thickness thresholds predictive of perioperative stroke.

Main Methods:

  • Transesophageal echocardiography was used to measure intimal thickness of the thoracic aorta.
  • 315 patients undergoing isolated CABG with cardiopulmonary bypass were studied.
  • Intimal thickness was correlated with the incidence of perioperative stroke.

Main Results:

  • Five patients (1.6%) experienced perioperative stroke or systemic emboli.
  • Mean intimal thickness at the aortic arch was significantly greater in stroke patients (6.94 mm) compared to non-stroke patients (2.78 mm).
  • An aortic arch intima thickness >5 mm was associated with a significantly higher incidence of perioperative stroke (p=0.007).

Conclusions:

  • Aortic arch intima thickness >5 mm indicates a high risk for perioperative stroke in CABG patients.
  • Preoperative assessment of aortic intimal thickness can aid in risk stratification.
  • Careful consideration of the CABG procedure is warranted for patients with thickened aortic intima to mitigate stroke risk.
Abstract

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