Why the study?
Does perioperative screening for aortic atherosclerosis with modified TEE and a systematic management protocol reduce postoperative mortality and cerebral complications in patients undergoing cardiac surgery?
Does perioperative screening for aortic atherosclerosis with modified TEE and a systematic management protocol reduce postoperative mortality and cerebral complications in patients undergoing cardiac surgery?
A systematic protocol combining modified TEE screening for aortic atherosclerosis with tailored intraoperative management may help reduce the risk of cerebral complications and mortality in cardiac surgery.
May justify routine modified TEE screening in cardiac surgery; extends prior strategies by integrating screening with tailored management to lower cerebral risks.
In patients undergoing cardiac surgery, use of perioperative screening for aortic atherosclerosis with modified TEE (A-View method) was associated with lower postoperative mortality, but not stroke, as compared to patients operated on without such screening. At the time of clinical implementation and validation, we did not yet standardize the indications for modified TEE and the changes in patient management in the presence of aortic atherosclerosis. Therefore, we designed a protocol, which combined the diagnosis of atherosclerosis of thoracic aorta and the subsequent considerations with respect to the intraoperative management and provides a systematic approach to reduce the risk of cerebral complications.
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Klomp et al. (2017) conducted a review in Aortic atherosclerosis in cardiac surgery patients. Modified transesophageal echocardiography (TEE A-View method) and epiaortic ultrasound screening protocol with tailored intraoperative surgical and anesthetic management vs. Standard cardiac surgery management without standardized aortic atherosclerosis screening protocol was evaluated. A standardized protocol combining modified TEE screening for thoracic aortic atherosclerosis with tailored intraoperative management is proposed to reduce cerebral complications in cardiac surgery.
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