Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Aortic Arch Endarterectomy Associated with On-Pump Cardiac Surgery in Patients with a Mobile Arch Atheroma

  • Song, Joon Young (Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital) ;
  • Choi, Jong Bum (Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital) ;
  • Kim, Jong Hun (Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital) ;
  • Kim, Kyung Hwa (Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital) ;
  • Kim, Tae Yun (Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital)
  • Received : 2018.07.12
  • Accepted : 2018.10.16
  • Published : 2019.04.05
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Abstract

We describe aortic arch endarterectomy performed concomitantly with on-pump cardiac surgery in 2 patients with grade V arch atherosclerosis. In both patients, transesophageal echocardiographic findings led to the diagnosis of severe arch atherosclerosis associated with a mobile atheromatous plaque in the aortic arch. The severe arch atherosclerosis was managed with endarterectomy under deep hypothermic circulatory arrest. In patients with severe grade V atherosclerosis in the aortic arch, performing endarterectomy simultaneously with primary cardiac surgery may be justified as a way to reduce the risk of peripheral embolism, including cerebrovascular accidents, with minimal additional surgical risk.

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References

  1. Khatibzadeh M, Mitusch R, Stierle U, Gromoll B, Sheikhzadeh A. Aortic atherosclerotic plaques as a source of systemic embolism. J Am Coll Cardiol 1996;27:664-9. https://doi.org/10.1016/0735-1097(95)00526-9
  2. Vaduganathan P, Ewton A, Nagueh SF, Weilbaecher DG, Safi HJ, Zoghbi WA. Pathologic correlates of aortic plaques, thrombi and mobile “aortic debris” imaged in vivo with transesophageal echocardiography. J Am Coll Cardiol 1997;30:357-63. https://doi.org/10.1016/S0735-1097(97)00181-2
  3. Amarenco P, Cohen A, Tzourio C, et al. Atherosclerotic disease of the aortic arch and the risk of ischemic stroke. N Engl J Med 1994;331:1474-9. https://doi.org/10.1056/NEJM199412013312202
  4. French Study of Aortic Plaques in Stroke Group, Amarenco P, Cohen A, et al. Atherosclerotic disease of the aortic arch as a risk factor for recurrent ischemic stroke. N Engl J Med 1996;334:1216-21. https://doi.org/10.1056/NEJM199605093341902
  5. Thenappan T, Ali Raza J, Movahed A. Aortic atheromas: current concepts and controversies: a review of the literature. Echocardiography 2008;25:198-207. https://doi.org/10.1111/j.1540-8175.2007.00568.x
  6. Tunick PA, Kronzon I. Atheromas of the thoracic aorta: clinical and therapeutic update. J Am Coll Cardiol 2000;35:545-54. https://doi.org/10.1016/S0735-1097(99)00604-X
  7. Vogt PR, Hauser M, Schwarz U, et al. Complete thromboendarterectomy of the calcified ascending aorta and aortic arch. Ann Thorac Surg 1999;67:457-61. https://doi.org/10.1016/S0003-4975(98)01239-9