Estenose carotídea e cirurgia de revascularização miocárdica

Rosa, Marcelo Pereira da; Portal, Vera Lúcia

doi:10.1590/s0104-42302011000300016

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…About 67.1% (51) of the patients with a stenosis ≥50% were male. [ 10 ] Mahmoudi et al . performed carotid duplex ultrasound in 878 patients before isolated CABG and found that 13% had a carotid stenosis >75%.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of carotid artery stenosis in neurologically asymptomatic patients undergoing coronary artery bypass grafting for coronary artery disease: Role of anesthesiologist in preoperative assessment and intraoperative management

et al. 2016

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Objective(s):This study aimed to determine the prevalence of carotid artery stenosis (CAS) due to atherosclerosis in neurologically asymptomatic patients undergoing coronary artery bypass grafting (CABG) for coronary artery disease (CAD). It contemplated a greater role for the cardiac anesthesiologist in the perioperative management of such patients with either previously undiagnosed carotid artery disease or towards re-assessment of severity of CAS.Design:Prospective, observational clinical study.Setting:Operation room of a cardiac surgery centre of a tertiary teaching hospital.Participants:A hundred adult patients with New York Heart Association (NYHA) classification I to III presenting electively for CABG.Interventions:All patients included in this study were subjected to ultrasonic examination by means of acarotid doppler scan to access for presence of CAS just prior to induction of general anesthesia.Measurements and Main Results:Based on parameters measured using carotid doppler, the presence of CAS was defined using standard criteria. The prevalence of CAS was found to be as high as 38% amongst the patients included in our study. The risk factors for CAS were identified to be advanced age, history of smoking, diabetes mellitus, dyslipidaemia and presence of a carotid bruit.Conclusion:This study points towards the relatively wide prevalence of carotid artery disease in neurologically asymptomatic patients undergoing CABG for CAD in the elective setting. It highlights the need to routinely incorporate carotid ultrasonography in the armamentarium of the cardiac anesthesiologist as standard of care for all patients presenting for CABG.

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Section: Discussionmentioning

confidence: 99%

“…[ 14 16 ] Carotid murmur was detected in 15.6% (6 patients) of the patients who has CAS in our study while da Rosa and Portal found it to be 35.5% (27 patients). [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

Prevalence of carotid artery stenosis in neurologically asymptomatic patients undergoing coronary artery bypass grafting for coronary artery disease: Role of anesthesiologist in preoperative assessment and intraoperative management

et al. 2016

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“…There is a high association between PAD, coronary artery disease and carotid artery disease, which predisposes these patients to an increased risk of myocardial infarction, ischemic stroke and vascular death, with the relative risk of mortality increased by three times for all causes, and by six times for vascular death, as seen by Durazzo et al [ 18 ] . According to Rosa & Portal [ 19 ] , carotid disease increases by four times the risk of perioperative stroke. PAD is more prevalent after the fourth decade of life, with the risk increasing two to three times every 10 years, and is associated with the following cardiovascular risk factors: smoking, DM, hypertension, and dyslipidemia [ 18 , 20 ] .…”

Section: Discussionmentioning

confidence: 99%

Predictors of stroke in patients undergoing cardiac surgery

Santos¹,

Magedanz²,

Guaragna³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveTo determine the risk factors related to the development of stroke in patients undergoing cardiac surgery.MethodsA historical cohort study. We included 4626 patients aged > 18 years who underwent coronary artery bypass surgery, heart valve replacement surgery alone or heart valve surgery combined with coronary artery bypass grafting between January 1996 and December 2011. The relationship between risk predictors and stroke was assessed by logistic regression model with a significance level of 0.05.ResultsThe incidence of stroke was 3% in the overall sample. After logistic regression, the following risk predictors for stroke were found: age 50-65 years (OR=2.11 - 95% CI 1.05-4.23 - P=0.036) and age >66 years (OR=3.22 - 95% CI 1.6-6.47 - P=0.001), urgent and emergency surgery (OR=2.03 - 95% CI 1.20-3.45 - P=0.008), aortic valve disease (OR=2.32 - 95% CI 1.18-4.56 - P=0.014), history of atrial fibrillation (OR=1.88 - 95% CI 1.05-3.34 - P=0.032), peripheral artery disease (OR=1.81 - 95% CI 1.13-2.92 - P=0.014), history of cerebrovascular disease (OR=3.42 - 95% CI 2.19-5.35 - P<0.001) and cardiopulmonary bypass time > 110 minutes (OR=1.71 - 95% CI 1.16-2.53 - P=0.007). Mortality was 31.9% in the stroke group and 8.5% in the control group (OR=5.06 - 95% CI 3.5-7.33 - P<0.001).ConclusionThe study identified the following risk predictors for stroke after cardiac surgery: age, urgent and emergency surgery, aortic valve disease, history of atrial fibrillation, peripheral artery disease, history of cerebrovascular disease and cardiopulmonary bypass time > 110 minutes.

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“…The incidence of stroke after CABG in patients with severe carotid occlusive disease is high, such timely identification of high-risk patients is one of the advantages. [ 10 11 ]…”

Section: Discussionmentioning

confidence: 99%

Routine preoperative doppler ultrasound examination of arterial system in patients undergoing cardiac surgery is beneficial: A retrospective study

et al. 2020

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Background: Presence of peripheral vascular disease enhances surgical risk in cardiac surgical patients. Prior knowledge of peripheral arterial disease may help the physician make changes in the monitoring and cardiopulmonary bypass cannulation plans. It is claimed that the incidence of peripheral vascular disease in cardiac surgical patients ranges from 11 to 30%. Aims: This study was conducted to understand the characteristics of peripheral vascular disease and their implication on cardiac surgery. Settings and Design: This was a prospective study undertaken in a tertiary referral hospital. Materials and Methods: All adult patients who underwent cardiac surgery during the period of six months were included. A Doppler examination of the neck, upper limb, abdomen and lower limb was carried out by our inhouse radiologist. The incidence of peripheral vascular disease, the implication on invasive pressure monitoring site and cannulation for cardiopulmonary bypass or intraaortic balloon pump or extracorporeal membrane oxygenation were made note of. Results: During the said period, six hundred twenty eight patients underwent cardiac surgery, of whom five hundred and sixty-one patients who underwent CABG surgery. All these were subjected to Doppler examination. We observed peripheral arterial disease in 105 patients (20%). In general men suffered from PAD more often than women. Monitoring site of invasive arterial pressure, the choice of beating heart surgery, insertion of intraaortic balloon pump, femoral arterial route for cardiopulmonary bypass were some of the decision that were altered. Conclusions: Performing Doppler examination in cardiac surgical patients may yield important data that might prevent complications and support patient safety.

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Estenose carotídea e cirurgia de revascularização miocárdica

Abstract: CS showed a high prevalence in the study sample and together with CRF was a mortality independent factor.

Cited by 3 publications

References 27 publications

Prevalence of carotid artery stenosis in neurologically asymptomatic patients undergoing coronary artery bypass grafting for coronary artery disease: Role of anesthesiologist in preoperative assessment and intraoperative management

Prevalence of carotid artery stenosis in neurologically asymptomatic patients undergoing coronary artery bypass grafting for coronary artery disease: Role of anesthesiologist in preoperative assessment and intraoperative management

Predictors of stroke in patients undergoing cardiac surgery

Routine preoperative doppler ultrasound examination of arterial system in patients undergoing cardiac surgery is beneficial: A retrospective study

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