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Do particulate emboli from the ascending aorta in coronary bypass grafting correlate with aortic wall thickness?

Johannes Bonatti1, Wim Jan van Boven, Georg Nagele

  • 1Innsbruck University Hospital, Innsbruck, Austria. johannes.o.bonatti@uibk.ac.at

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

Embolic load during coronary artery bypass grafting is not linked to aortic atherosclerosis extent. This finding suggests embolic debris is independent of aortic wall thickness in patients undergoing this procedure.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Biology
  • Medical Device Technology

Background:

  • Ascending aortic atherosclerosis is a risk factor for embolic events during cardiac surgery.
  • The relationship between aortic plaque burden and embolic load during coronary artery bypass grafting (CABG) remains unclear.

Purpose of the Study:

  • To investigate the association between embolic load and ascending aortic atherosclerosis extent during on-pump, arrested heart CABG.
  • To determine if aortic wall thickness predicts the amount of particulate debris captured during surgery.

Main Methods:

  • 113 patients undergoing isolated arrested heart CABG were studied.
  • Ascending aortic wall thickness was measured using epiaortic ultrasound.
  • An intraaortic filter (EMBOL-X System) captured embolic debris, which was then quantified by particle number and surface area.

Main Results:

  • Particulate debris was detected in 96% of filters, with a mean of 6.8 particles and 5.5 mm² surface area.
  • No significant correlation was found between embolic load (particle number or surface area) and any aortic wall thickness measurements.
  • Aortic wall thickness measures (total, distal, mid, proximal) were 27.4±4.4 mm, 9.5±2.0 mm, 9.0±1.9 mm, and 8.8±1.4 mm, respectively.

Conclusions:

  • Embolic load captured during on-pump, arrested heart CABG appears independent of the extent of ascending aortic atherosclerosis.
  • These findings suggest that for patients with low to moderate aortic pathology, aortic wall thickness does not predict embolic debris during this surgical procedure.

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