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Published on: March 26, 2018

Extent of thoracic aortic atheroma burden and long-term mortality after cardiothoracic surgery: a computed tomography

Vikram Kurra1, Michael L Lieber, Srikanth Sola

  • 1Imaging Institute, Cleveland Clinic, Cleveland, Ohio 44106, USA.

JACC. Cardiovascular Imaging
|October 16, 2010
PubMed

Insights

The extent of thoracic aortic atheroma, measured by multidetector-row computed tomographic angiography (MDCTA), predicts long-term mortality after cardiothoracic surgery. Higher plaque burden indicates increased risk for patients undergoing heart procedures.

Area of Science:

  • Cardiovascular Imaging and Intervention
  • Atherosclerosis Research
  • Thoracic Surgery Outcomes

Background:

  • Severe aortic atheroma is linked to adverse outcomes after cardiothoracic surgery.
  • The specific impact of overall aortic plaque burden on long-term mortality remains unclear.

Purpose of the Study:

  • To investigate the association between the extent of thoracic aortic atheroma and long-term mortality.
  • To determine if pre-operative multidetector-row computed tomographic angiography (MDCTA) can predict mortality risk in patients undergoing nonaortic cardiothoracic surgery.

Main Methods:

  • Retrospective review of 862 patients undergoing MDCTA before coronary bypass or valvular heart surgery (2002-2008).
  • Analysis of aortic atheroma extent and thickness across 5 thoracic segments.
  • Calculation of a semiquantitative total plaque-burden score (TPBS) ranging from 0 to 30.

Main Results:

  • The mean TPBS was 8.6 (SD: ±6.0) in 862 patients (67.8 years, 71% male).
  • TPBS was a significant independent predictor of all-cause mortality (p < 0.0001), with a hazard ratio of 1.08.
  • Independent predictors of mortality included TPBS, glomerular filtration rate, surgery type, and peripheral artery disease.

Conclusions:

  • Increased thoracic aortic atheroma burden is independently associated with higher long-term mortality post-cardiothoracic surgery.
  • Findings suggest a link to systemic atherosclerotic disease, impacting secondary prevention strategies in post-operative care.
Abstract

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