Home > Journals > Minerva Cardioangiologica > Past Issues > Minerva Cardioangiologica 2007 April;55(2) > Minerva Cardioangiologica 2007 April;55(2):267-74

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe PROMO
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints

 

REVIEWS  ECHOCARDIOGRAPHY IN THE CARDIAC SURGERY PATIENT 

Minerva Cardioangiologica 2007 April;55(2):267-74

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

Role of echocardiography in aortic atherosclerotic disease and stroke

Molisse T., Tunick P. A., Kronzon I.

Leon Charney Division of Cardiology Department of Medicine New York University School of Medicine New York, NY, USA


PDF


Patients with severe aortic atherosclerosis are at high risk for stroke. The risk is highest for those with atherosclerotic plaque measuring ≥4 mm in thickness. There is currently no proven medical therapy to reduce embolic risk in patients with aortic plaque. Antiplatelet therapy, smoking cessation, and management of diabetes and hypertension are important. Retrospective data support the use of statins to prevent stroke in patients with severe aortic plaque. Embolism from aortic atherosclerosis may occur spontaneously, or less commonly, as a complication of invasive or surgical cardiovascular procedures. Transesophageal echocardiography (TEE) is the procedure of choice for the characterization of plaque and the detection of superimposed mobile thrombi. Therefore, TEE is a useful tool to identify patients at high risk for stroke. For patients who are being evaluated for coronary artery bypass graft (CABG) surgery or coronary angiography, the risks and benefits of these procedures must be carefully weighed and alternate approaches should be considered in patients with severe plaque. Options include off-pump CABG or coronary angiography via a brachial (rather than femoral) approach.

top of page