Thickened intima of the aortic arch is a risk factor for stroke with coronary artery bypass grafting

On-Pump Beating Heart Mitral Valve Surgery without Cross-Clamping the Aorta

“…8 Proximal aortic arteriosclerosis is the source of macro-and microemboli at the time of placement and release of the aortic cross-clamp. [16][17][18][19] Many studies demonstrated that unilateral middle cerebral artery embolus closely correlates with vascular manipulations that occur within the first 4 minutes of aortic cross-clamp manipulation. [20][21][22] Mitral valve replacement (MVR) without cross-clamping the aorta may reduce risk of micro-and macroembolic load, which may occur during manipulation of the aorta.…”

Neurocognitive Functions after Beating Heart Mitral Valve Replacement without Cross-Clamping the Aorta

“…On the other hand, recent studies report similar incidence of neuropsychological dysfunction after coronary surgery with and without usage of cardiopulmonary bypass 24–26 . Proximal aortic arteriosclerosis may lead to macroemboli and microemboli during application of cross‐clamp to aorta and its removal from the aorta 4–6 . Many studies demonstrated that the unilateral middle cerebral artery embolism was closely correlated to vascular manipulations, and within the first four minutes of aortic cross‐clamp manipulation (applying and release of cross‐clamp) 27,28 .…”

“…The interaction between cerebral embolization, hypoperfusion, and local/systemic inflammatory processes may add more risk to the central nervous system injury during cardiac surgery 3 . Proximal aortic arteriosclerosis is also a source of macroemboli and microemboli during clamping and declamping of the aorta 4–6 …”

Off-pump coronary bypass surgery: risk of ischemic brain lesions in patients with atheromatous thoracic aorta

“…[1][2][3] Atherosclerosis of the ascending aorta and the aortic arch is one of the most important risk factors for perioperative stroke. [4][5][6][7][8] Recently, we reported that patients with atheromatous disease of the proximal thoracic aorta (ascending aorta and aortic arch) undergoing coronary artery bypass (CAB) surgery with cardiopulmonary bypass (CPB) were exposed to a high risk of ischemic brain injury as identified by diffusion-weighted magnetic resonance imaging (DW-MRI). These patients had a threefold increase in cerebral embolic load during CPB, and a change in postoperative mental status when compared to patients with a normal aorta.…”

“…5,10 The same weighting criteria were applied to the presence of atheroma in the ascending aorta, and the aortic arch. Only patients with grade 1 or grade 2 atheroma were included in this study.…”