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A Protocol for Diagnosis and Management of Aortic Atherosclerosis in Cardiac Surgery Patients

Wouter W Jansen Klomp1,2, George J Brandon Bravo Bruinsma3, Arnoud W J Van 't Hof1,4

  • 1Department of Cardiology, Isala, Dokter van Heesweg 2, 8025 AB Zwolle, Netherlands.

International Journal of Vascular Medicine
|August 31, 2017
PubMed

Insights

Perioperative screening for aortic atherosclerosis using the A-View method in cardiac surgery patients reduced mortality. This study aimed to standardize this screening and management protocol to further minimize cerebral complication risks.

Area of Science:

  • Cardiovascular Surgery
  • Diagnostic Imaging
  • Vascular Medicine

Background:

  • Aortic atherosclerosis is a risk factor in cardiac surgery.
  • Modified transesophageal echocardiography (TEE) screening (A-View method) showed potential in reducing mortality.
  • Lack of standardized protocols for screening and management hindered widespread adoption.

Purpose of the Study:

  • To develop and propose a standardized protocol for perioperative screening of thoracic aortic atherosclerosis.
  • To integrate atherosclerosis diagnosis with intraoperative management strategies.
  • To systematically reduce the risk of cerebral complications in cardiac surgery patients.

Main Methods:

  • Development of a protocol combining atherosclerosis diagnosis via modified TEE (A-View method) and intraoperative management.
  • Focus on a systematic approach to patient care during cardiac surgery.

Main Results:

  • Modified TEE screening was associated with lower postoperative mortality compared to no screening.
  • Screening did not show a significant association with reduced stroke rates.
  • The study highlights the need for standardized protocols for effective risk reduction.

Conclusions:

  • A standardized protocol for aortic atherosclerosis screening and management in cardiac surgery is crucial.
  • Implementing such protocols may improve patient outcomes by reducing mortality.
  • Further research is needed to optimize stroke risk reduction strategies in conjunction with screening.

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