Grocott Hilary P, Tran Tony
Department of Anesthesia, University of Manitoba, Winnipeg, Manitoba, Canada.
Semin Cardiothorac Vasc Anesth. 2010 Jun;14(2):86-94. doi: 10.1177/1089253210371522.
Aortic atheromatous disease is a common finding in the patient presenting for cardiac surgery. Adverse neurologic outcome has been closely linked to the extent of aortic atherosclerosis. In order to optimize perioperative outcomes, the location and severity of disease needs accurate characterization using multimodal techniques. Although various preoperative radiographic techniques have variably identified patients with significant atheroma, intraoperative echocardiographic imaging has proven most useful in localizing and characterizing the degree of aortic atheroma. Epiaortic assessment of the ascending aorta has been utilized in guiding surgical modifications and interventions aimed at reducing the risk of neurologic injury. Although no particular technique has been definitely studied, avoidance of the identifiable atheromatous aortic region has been a main feature of the various modifications employed to optimize neurologic outcome after cardiac surgery.
主动脉粥样硬化疾病在接受心脏手术的患者中很常见。不良神经学结局与主动脉粥样硬化的程度密切相关。为了优化围手术期结局，需要使用多模态技术准确描述疾病的位置和严重程度。尽管各种术前影像学技术对显著动脉粥样硬化患者的识别各不相同，但术中超声心动图成像已被证明在定位和描述主动脉粥样硬化程度方面最有用。升主动脉的主动脉外膜评估已被用于指导旨在降低神经损伤风险的手术改良和干预。虽然尚未对特定技术进行明确研究，但避免可识别的主动脉粥样硬化区域一直是为优化心脏手术后神经学结局而采用的各种改良措施的主要特点。
