Aortic assessment for cardiac surgical procedures

Area of Science:

• Cardiovascular Surgery
• Neurology
• Vascular Medicine

Background:

• Aortic atheromatous disease and reduced aortic compliance are linked to stroke risk in ambulatory and perioperative patients.
• Atherosclerosis involves atheromatous deposits and collagen-induced stiffening of the aorta.
• These vascular changes can be quantified using transesophageal echocardiography.

Purpose of the Study:

• To review the literature on the utility of transesophageal echocardiography in assessing the aorta during cardiac surgery.
• To evaluate methods for reducing perioperative stroke associated with aortic disease.
• To discuss the role of medical therapies in stroke prevention post-cardiac surgery.

Main Methods:

• Literature review of studies investigating transesophageal echocardiography for aortic assessment.
• Analysis of surgical techniques aimed at modifying procedures based on aortic findings.
• Examination of data on aortic lesion removal and medical management strategies.

Main Results:

• Transesophageal echocardiography (TEE) examination of the aorta is supported by literature for reducing stroke after cardiac surgery via surgical technique modification.
• Surgical attempts to remove aortic atheromatous lesions carry a high perioperative mortality.
• Medical therapies like warfarin and statins may decrease stroke incidence post-heart surgery.

Conclusions:

• Transesophageal echocardiography is a valuable tool for assessing aortic disease and mitigating stroke risk in cardiac surgery patients.
• Direct surgical intervention on aortic lesions is currently associated with high mortality.
• Medical management remains a key strategy for preventing stroke in this population.