Routine intraoperative transesophageal echocardiography identifies patients with atheromatous aortas: impact on “off-pump” coronary artery bypass and perioperative stroke
Patients with severe atheromatous aortic disease (AAD) undergoing coronary artery bypass grafting (CABG) have increased operative risks. The “off-pump” CABG (OPCAB) technique was evaluated in patients given the diagnosis of severe AAD by routine transesophageal echocardiography. A total of 5737 pati...
Gespeichert in:
| Veröffentlicht in: | Journal of the American Society of Echocardiography 2003-07, Vol.16 (7), p.751-755 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 755 |
|---|---|
| container_issue | 7 |
| container_start_page | 751 |
| container_title | Journal of the American Society of Echocardiography |
| container_volume | 16 |
| creator | Grossi, Eugene A Bizekis, Costas S Sharony, Ram Saunders, Paul C Galloway, Aubrey C LaPietra, Angelo Applebaum, Robert M Esposito, Rick A Ribakove, Greg H Culliford, Alfred T Kanchuger, Marc Kronzon, Itzhak Colvin, Stephen B |
| description | Patients with severe atheromatous aortic disease (AAD) undergoing coronary artery bypass grafting (CABG) have increased operative risks. The “off-pump” CABG (OPCAB) technique was evaluated in patients given the diagnosis of severe AAD by routine transesophageal echocardiography.
A total of 5737 patients underwent CABG, with 913 having transesophageal echocardiography findings of severe AAD. Of the patients with severe AAD, 678 (74.3%) had conventional CABG and 235 (25.7%) had OPCAB.
Hospital mortality was 8.7% for conventional CABG and 5.1% for OPCAB (
P = .08). Multivariate analysis revealed that increased mortality was significantly associated with acute myocardial infarction, conventional CABG, age, renal disease, history of stroke, and ejection fraction < 30%. Neurologic complications occurred in 6.3% of patients undergoing CABG and in 2.1% undergoing OPCAB (
P = .01). Freedom from any complication was significantly greater with OPCAB.
Routine intraoperative transesophageal echocardiography identifies patients with severe AAD. In these patients, OPCAB technique is associated with a lower risk of death, stroke, and all complications. |
| doi_str_mv | 10.1016/S0894-7317(03)00284-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73425805</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0894731703002840</els_id><sourcerecordid>73425805</sourcerecordid><originalsourceid>FETCH-LOGICAL-c361t-840307b2a13c59f8b93a28fec285a7cfa5332c770c49492635833c27e13dbd323</originalsourceid><addsrcrecordid>eNqFkc1u1TAQhS1ERW8vPALIK0QXAf8kccKmQhXQSpUq8bO2Js6kMdzExnaK7q4PAq_AQ_VJcHuv6JLVeKTveObMIeQ5Z6854_Wbz6xpy0JJrl4xecyYaMqCPSIrzlpV1KqtHpPVP-SQHMX4jTFWNYw9IYdcNLKqa7Eifz65JdkZqZ1TAOcxQLLXSHMzR4zOj3CFsKFoRmcg9NZdBfDjltoe52QHi5H6LMlNpD9tGimkEYObILklUnAhQXxL7eTBJOpmenvzyw1D4ZfJ3978psYFN0PYUggJc-m2HmLWzT3Nu9iHhWIK7js-JQcDbCI-29c1-frh_ZfTs-Li8uP56buLwsiap6IpmWSqE8Clqdqh6VoJohnQiKYCZQaopBRGKWbKtmxFLatGSiMUctl3vRRyTV7u_vXB_VgwJj3ZaHCzgRmzL61kKfItqwxWO9AEF2PAQftgp2xIc6bvgtL3Qem7FDST-j6o_FiTF_sBSzdh_6DaJ5OBkx2A2ea1xaCjyVc22NuAJune2f-M-Av9yKpg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73425805</pqid></control><display><type>article</type><title>Routine intraoperative transesophageal echocardiography identifies patients with atheromatous aortas: impact on “off-pump” coronary artery bypass and perioperative stroke</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Grossi, Eugene A ; Bizekis, Costas S ; Sharony, Ram ; Saunders, Paul C ; Galloway, Aubrey C ; LaPietra, Angelo ; Applebaum, Robert M ; Esposito, Rick A ; Ribakove, Greg H ; Culliford, Alfred T ; Kanchuger, Marc ; Kronzon, Itzhak ; Colvin, Stephen B</creator><creatorcontrib>Grossi, Eugene A ; Bizekis, Costas S ; Sharony, Ram ; Saunders, Paul C ; Galloway, Aubrey C ; LaPietra, Angelo ; Applebaum, Robert M ; Esposito, Rick A ; Ribakove, Greg H ; Culliford, Alfred T ; Kanchuger, Marc ; Kronzon, Itzhak ; Colvin, Stephen B</creatorcontrib><description>Patients with severe atheromatous aortic disease (AAD) undergoing coronary artery bypass grafting (CABG) have increased operative risks. The “off-pump” CABG (OPCAB) technique was evaluated in patients given the diagnosis of severe AAD by routine transesophageal echocardiography.
A total of 5737 patients underwent CABG, with 913 having transesophageal echocardiography findings of severe AAD. Of the patients with severe AAD, 678 (74.3%) had conventional CABG and 235 (25.7%) had OPCAB.
Hospital mortality was 8.7% for conventional CABG and 5.1% for OPCAB (
P = .08). Multivariate analysis revealed that increased mortality was significantly associated with acute myocardial infarction, conventional CABG, age, renal disease, history of stroke, and ejection fraction < 30%. Neurologic complications occurred in 6.3% of patients undergoing CABG and in 2.1% undergoing OPCAB (
P = .01). Freedom from any complication was significantly greater with OPCAB.
Routine intraoperative transesophageal echocardiography identifies patients with severe AAD. In these patients, OPCAB technique is associated with a lower risk of death, stroke, and all complications.</description><identifier>ISSN: 0894-7317</identifier><identifier>EISSN: 1097-6795</identifier><identifier>DOI: 10.1016/S0894-7317(03)00284-0</identifier><identifier>PMID: 12835662</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Aged ; Aortic Diseases - diagnostic imaging ; Arteriosclerosis - diagnostic imaging ; Case-Control Studies ; Coronary Artery Bypass - methods ; Coronary Artery Bypass - mortality ; Echocardiography, Transesophageal ; Female ; Hospital Mortality ; Humans ; Intraoperative Care ; Male ; Multivariate Analysis ; Nervous System Diseases - epidemiology ; Postoperative Complications - epidemiology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stroke - epidemiology</subject><ispartof>Journal of the American Society of Echocardiography, 2003-07, Vol.16 (7), p.751-755</ispartof><rights>2003 Elsevier Science Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-840307b2a13c59f8b93a28fec285a7cfa5332c770c49492635833c27e13dbd323</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0894-7317(03)00284-0$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12835662$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grossi, Eugene A</creatorcontrib><creatorcontrib>Bizekis, Costas S</creatorcontrib><creatorcontrib>Sharony, Ram</creatorcontrib><creatorcontrib>Saunders, Paul C</creatorcontrib><creatorcontrib>Galloway, Aubrey C</creatorcontrib><creatorcontrib>LaPietra, Angelo</creatorcontrib><creatorcontrib>Applebaum, Robert M</creatorcontrib><creatorcontrib>Esposito, Rick A</creatorcontrib><creatorcontrib>Ribakove, Greg H</creatorcontrib><creatorcontrib>Culliford, Alfred T</creatorcontrib><creatorcontrib>Kanchuger, Marc</creatorcontrib><creatorcontrib>Kronzon, Itzhak</creatorcontrib><creatorcontrib>Colvin, Stephen B</creatorcontrib><title>Routine intraoperative transesophageal echocardiography identifies patients with atheromatous aortas: impact on “off-pump” coronary artery bypass and perioperative stroke</title><title>Journal of the American Society of Echocardiography</title><addtitle>J Am Soc Echocardiogr</addtitle><description>Patients with severe atheromatous aortic disease (AAD) undergoing coronary artery bypass grafting (CABG) have increased operative risks. The “off-pump” CABG (OPCAB) technique was evaluated in patients given the diagnosis of severe AAD by routine transesophageal echocardiography.
A total of 5737 patients underwent CABG, with 913 having transesophageal echocardiography findings of severe AAD. Of the patients with severe AAD, 678 (74.3%) had conventional CABG and 235 (25.7%) had OPCAB.
Hospital mortality was 8.7% for conventional CABG and 5.1% for OPCAB (
P = .08). Multivariate analysis revealed that increased mortality was significantly associated with acute myocardial infarction, conventional CABG, age, renal disease, history of stroke, and ejection fraction < 30%. Neurologic complications occurred in 6.3% of patients undergoing CABG and in 2.1% undergoing OPCAB (
P = .01). Freedom from any complication was significantly greater with OPCAB.
Routine intraoperative transesophageal echocardiography identifies patients with severe AAD. In these patients, OPCAB technique is associated with a lower risk of death, stroke, and all complications.</description><subject>Aged</subject><subject>Aortic Diseases - diagnostic imaging</subject><subject>Arteriosclerosis - diagnostic imaging</subject><subject>Case-Control Studies</subject><subject>Coronary Artery Bypass - methods</subject><subject>Coronary Artery Bypass - mortality</subject><subject>Echocardiography, Transesophageal</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Intraoperative Care</subject><subject>Male</subject><subject>Multivariate Analysis</subject><subject>Nervous System Diseases - epidemiology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke - epidemiology</subject><issn>0894-7317</issn><issn>1097-6795</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1u1TAQhS1ERW8vPALIK0QXAf8kccKmQhXQSpUq8bO2Js6kMdzExnaK7q4PAq_AQ_VJcHuv6JLVeKTveObMIeQ5Z6854_Wbz6xpy0JJrl4xecyYaMqCPSIrzlpV1KqtHpPVP-SQHMX4jTFWNYw9IYdcNLKqa7Eifz65JdkZqZ1TAOcxQLLXSHMzR4zOj3CFsKFoRmcg9NZdBfDjltoe52QHi5H6LMlNpD9tGimkEYObILklUnAhQXxL7eTBJOpmenvzyw1D4ZfJ3978psYFN0PYUggJc-m2HmLWzT3Nu9iHhWIK7js-JQcDbCI-29c1-frh_ZfTs-Li8uP56buLwsiap6IpmWSqE8Clqdqh6VoJohnQiKYCZQaopBRGKWbKtmxFLatGSiMUctl3vRRyTV7u_vXB_VgwJj3ZaHCzgRmzL61kKfItqwxWO9AEF2PAQftgp2xIc6bvgtL3Qem7FDST-j6o_FiTF_sBSzdh_6DaJ5OBkx2A2ea1xaCjyVc22NuAJune2f-M-Av9yKpg</recordid><startdate>20030701</startdate><enddate>20030701</enddate><creator>Grossi, Eugene A</creator><creator>Bizekis, Costas S</creator><creator>Sharony, Ram</creator><creator>Saunders, Paul C</creator><creator>Galloway, Aubrey C</creator><creator>LaPietra, Angelo</creator><creator>Applebaum, Robert M</creator><creator>Esposito, Rick A</creator><creator>Ribakove, Greg H</creator><creator>Culliford, Alfred T</creator><creator>Kanchuger, Marc</creator><creator>Kronzon, Itzhak</creator><creator>Colvin, Stephen B</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030701</creationdate><title>Routine intraoperative transesophageal echocardiography identifies patients with atheromatous aortas: impact on “off-pump” coronary artery bypass and perioperative stroke</title><author>Grossi, Eugene A ; Bizekis, Costas S ; Sharony, Ram ; Saunders, Paul C ; Galloway, Aubrey C ; LaPietra, Angelo ; Applebaum, Robert M ; Esposito, Rick A ; Ribakove, Greg H ; Culliford, Alfred T ; Kanchuger, Marc ; Kronzon, Itzhak ; Colvin, Stephen B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-840307b2a13c59f8b93a28fec285a7cfa5332c770c49492635833c27e13dbd323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Aortic Diseases - diagnostic imaging</topic><topic>Arteriosclerosis - diagnostic imaging</topic><topic>Case-Control Studies</topic><topic>Coronary Artery Bypass - methods</topic><topic>Coronary Artery Bypass - mortality</topic><topic>Echocardiography, Transesophageal</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Intraoperative Care</topic><topic>Male</topic><topic>Multivariate Analysis</topic><topic>Nervous System Diseases - epidemiology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grossi, Eugene A</creatorcontrib><creatorcontrib>Bizekis, Costas S</creatorcontrib><creatorcontrib>Sharony, Ram</creatorcontrib><creatorcontrib>Saunders, Paul C</creatorcontrib><creatorcontrib>Galloway, Aubrey C</creatorcontrib><creatorcontrib>LaPietra, Angelo</creatorcontrib><creatorcontrib>Applebaum, Robert M</creatorcontrib><creatorcontrib>Esposito, Rick A</creatorcontrib><creatorcontrib>Ribakove, Greg H</creatorcontrib><creatorcontrib>Culliford, Alfred T</creatorcontrib><creatorcontrib>Kanchuger, Marc</creatorcontrib><creatorcontrib>Kronzon, Itzhak</creatorcontrib><creatorcontrib>Colvin, Stephen B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grossi, Eugene A</au><au>Bizekis, Costas S</au><au>Sharony, Ram</au><au>Saunders, Paul C</au><au>Galloway, Aubrey C</au><au>LaPietra, Angelo</au><au>Applebaum, Robert M</au><au>Esposito, Rick A</au><au>Ribakove, Greg H</au><au>Culliford, Alfred T</au><au>Kanchuger, Marc</au><au>Kronzon, Itzhak</au><au>Colvin, Stephen B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Routine intraoperative transesophageal echocardiography identifies patients with atheromatous aortas: impact on “off-pump” coronary artery bypass and perioperative stroke</atitle><jtitle>Journal of the American Society of Echocardiography</jtitle><addtitle>J Am Soc Echocardiogr</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>16</volume><issue>7</issue><spage>751</spage><epage>755</epage><pages>751-755</pages><issn>0894-7317</issn><eissn>1097-6795</eissn><abstract>Patients with severe atheromatous aortic disease (AAD) undergoing coronary artery bypass grafting (CABG) have increased operative risks. The “off-pump” CABG (OPCAB) technique was evaluated in patients given the diagnosis of severe AAD by routine transesophageal echocardiography.
A total of 5737 patients underwent CABG, with 913 having transesophageal echocardiography findings of severe AAD. Of the patients with severe AAD, 678 (74.3%) had conventional CABG and 235 (25.7%) had OPCAB.
Hospital mortality was 8.7% for conventional CABG and 5.1% for OPCAB (
P = .08). Multivariate analysis revealed that increased mortality was significantly associated with acute myocardial infarction, conventional CABG, age, renal disease, history of stroke, and ejection fraction < 30%. Neurologic complications occurred in 6.3% of patients undergoing CABG and in 2.1% undergoing OPCAB (
P = .01). Freedom from any complication was significantly greater with OPCAB.
Routine intraoperative transesophageal echocardiography identifies patients with severe AAD. In these patients, OPCAB technique is associated with a lower risk of death, stroke, and all complications.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>12835662</pmid><doi>10.1016/S0894-7317(03)00284-0</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0894-7317 |
| ispartof | Journal of the American Society of Echocardiography, 2003-07, Vol.16 (7), p.751-755 |
| issn | 0894-7317 1097-6795 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_73425805 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aged Aortic Diseases - diagnostic imaging Arteriosclerosis - diagnostic imaging Case-Control Studies Coronary Artery Bypass - methods Coronary Artery Bypass - mortality Echocardiography, Transesophageal Female Hospital Mortality Humans Intraoperative Care Male Multivariate Analysis Nervous System Diseases - epidemiology Postoperative Complications - epidemiology Retrospective Studies Risk Assessment Risk Factors Stroke - epidemiology |
| title | Routine intraoperative transesophageal echocardiography identifies patients with atheromatous aortas: impact on “off-pump” coronary artery bypass and perioperative stroke |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T01%3A18%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Routine%20intraoperative%20transesophageal%20echocardiography%20identifies%20patients%20with%20atheromatous%20aortas:%20impact%20on%20%E2%80%9Coff-pump%E2%80%9D%20coronary%20artery%20bypass%20and%20perioperative%20stroke&rft.jtitle=Journal%20of%20the%20American%20Society%20of%20Echocardiography&rft.au=Grossi,%20Eugene%20A&rft.date=2003-07-01&rft.volume=16&rft.issue=7&rft.spage=751&rft.epage=755&rft.pages=751-755&rft.issn=0894-7317&rft.eissn=1097-6795&rft_id=info:doi/10.1016/S0894-7317(03)00284-0&rft_dat=%3Cproquest_cross%3E73425805%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=73425805&rft_id=info:pmid/12835662&rft_els_id=S0894731703002840&rfr_iscdi=true |