Determination of size of aortic emboli and embolic load during coronary artery bypass grafting

Barbut, Denise; Yao, Fun Sun F.; Lo, Yi Wen; Silverman, Ronald P.; Hager, David N.; Trifiletti, Rosario Rich; Gold, Jeffrey P.

doi:10.1016/s0003-4975(97)80352-9

Cited by 83 publications

(31 citation statements)

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“…In off-pump cases where an anastomosis device was used without a partial clamp, particulate debris was reduced but not eliminated [15]. Removal of the aortic cross-clamp is associated with 34% of embolic signals during CABG, and another 24% of signals were detected after removal of the partial clamp for proximal anastomoses in a study by Barbut and colleagues [16,17]. Other studies by Aranki and colleagues and Bertolini and colleagues [7,8] also implicated the partial occlusion clamp as a source of atheroemboli release and associated complications.…”

Section: Discussionmentioning

confidence: 99%

Automatic connector devices for proximal anastomoses do not decrease embolic debris compared with conventional anastomoses in CABG1

Martens

Dietrich

Herzog

et al. 2004

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Automatic connector devices for proximal anastomoses do not decrease embolic debris compared with conventional anastomoses in CABG1

Martens

Dietrich

Herzog

et al. 2004

European Journal of Cardio-Thoracic Surgery

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“…Patients with a heavily diseased ascending aorta have a higher risk for embolic complications from dislodged atheromatous debris with cannulation, cardiopulmonary bypass, and aortic clamping. Studies utilizing transcranial Doppler ultrasonography have confirmed the production of aortic emboli associated with cannulation and application of aortic clamps [46][47][48]. Avoidance of aortic cannulation, cardiopulmonary bypass, aortic clamping, and the use of clampless anastomotic devices has been shown to decrease this embolic load [45,[49][50][51].…”

Section: Strokementioning

confidence: 95%

Off-pump coronary surgery: where do we stand in 2010?

Halkos

Puskas²

2010

Current Opinion in Cardiology

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“…Several studies have shown that significant emboli occur not only during CPB but also after removal of the partial clamp [50,51]. One of the investigations described an efficiency of a proximal anastomosis device which does not require aortic clamping.…”

Section: Aorta No-touch Techniquesmentioning

confidence: 99%

Stroke associated with coronary artery bypass grafting

Arai

2015

Gen Thorac Cardiovasc Surg

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While coronary artery bypass grafting (CABG) has been playing a significant role in the revascularization for ischemic heart disease, neurological complications associated with CABG have been a primary concern. Stroke, although the incidence is low, is one of the most devastating complication of CABG. Many studies have identified the risk factors for stroke with CABG, such as prior stroke, carotid artery stenosis, aortic atherosclerosis, atrial fibrillation and cardiopulmonary bypass. Various rational approaches focusing on individual risk factor have been proposed for the stroke. Prophylactic carotid revascularization is an important strategy, and the diagnosis of carotid stenosis has to be established correctly. Prevention of emboli from aortic plaque is also an essential issue. Intraoperative monitoring with transesophageal or epiaortic ultrasound is useful to identify mobile atheromatous plaques and to select appropriate aortic manipulations. Maintenance of cerebral blood flow and blood pressure during cardiopulmonary bypass might be critical issues. Besides, there are conflicting two opinions regarding off-pump CABG; one supports an efficiency for the prevention of stroke while the other advocates no effect. This discrepancy might be explained by the difference of the risk of stroke in the population of the individual study and by the variation of the percentage of aortic clamping or aortic anastomosis in each study. Pharmaceutical therapies such as statin, preventive medication for atrial fibrillation, or antiplatelet are promising methods. Although it is hard to decrease the incidence of the stroke with any single countermeasure, sustained effort should be continued to overcome the stroke associated with CABG.

show abstract

Determination of size of aortic emboli and embolic load during coronary artery bypass grafting

Cited by 83 publications

References 0 publications

Automatic connector devices for proximal anastomoses do not decrease embolic debris compared with conventional anastomoses in CABG1

Automatic connector devices for proximal anastomoses do not decrease embolic debris compared with conventional anastomoses in CABG1

Off-pump coronary surgery: where do we stand in 2010?

Stroke associated with coronary artery bypass grafting

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