Mobile atheromatous plaque of the aortic arch diagnosed by transthoracic echocardiography prior to coronary artery bypass surgery - which one would you choose : scepticism or wishful thinking? : case report - online article

A routine pre-operative chest X-ray of a patient admitted to our institution for an elective coronary artery bypass operation revealed a mildly dilated mediastinal silhouette, which led the cardiovascular surgery resident to schedule emergency transthoracic echocardiography (TTE), with a special not...

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Bibliographic Details
Published inCardiovascular Journal of Africa Vol. 23; no. 4; pp. 3 - 5
Main Authors Kucukoglu, S, Omay, O, Suzer, K, Baskurt, M, Hatemi, A.C, Oz, B
Format Journal Article
LanguageEnglish
Published Clinics Cardive Publishing 01.05.2012
Subjects
Aorta
Aortic arch
Atherosclerosis
CABG
Circulatory arrest
Coronary artery bypass grafts
Echocardiography
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Summary:A routine pre-operative chest X-ray of a patient admitted to our institution for an elective coronary artery bypass operation revealed a mildly dilated mediastinal silhouette, which led the cardiovascular surgery resident to schedule emergency transthoracic echocardiography (TTE), with a special note asking for detailed evaluation of the ascending aorta and aortic arch. TTE revealed a mobile atheroma at the aortic arch, which obliged the cardiac surgery team to modify their strategy to combined hemi-arcus aortae replacement and coronary artery bypass grafting (CABG). Although with transoesophageal echocardiography (TEE) a small portion of the ascending aorta may be obscured by the trachea, TEE provides higher resolution images than TTE. Therefore one can conclude that TEE is the imaging modality of choice for detecting aortic atheromatous plaques but in patients with low risk for stroke and aortic atheromas, a detailed TTE may be sufficient for the pre-operative assessment.
ISSN:1995-1892
1680-0745