TY - JOUR AU - Feuchtner, Gudrun Maria AU - Schachner, Thomas AU - Bonaros, Nikolaos AU - Smekal, Alexander AU - Mallouhi, Ammar AU - Friedrich, Guy J. AU - Deutschmann, Martin AU - Laufer, Guenther AU - Nedden, Dieter zur AU - Bonatti, Johannes PY - 2006/07/05 Y2 - 2024/03/28 TI - Evaluation of Ascending Aortic Atherosclerosis with 16-Multidetector Computed Tomography Is Useful before Total Endoscopic Coronary Bypass Surgery JF - The Heart Surgery Forum JA - HSF VL - 9 IS - 5 SE - DO - 10.1532/HSF98.20051103 UR - https://journal.hsforum.com/index.php/HSF/article/view/13 SP - E754-E758 AB - <p><b>Background.</b> The purpose of this study was to investigate the assessment of ascending aortic atherosclerosis with 16-multidetector computed tomography (16-MDCT) angiography prior to total endoscopic coronary artery bypass (TECAB) surgery.</p><p><b>Methods.</b> Forty-five patients were examined with electrocardiogram-gated, 16-MDCT angiography. The presence of atherosclerosis at the ascending aorta was graduated as severe (>50% of circumference) or as mild (<50% of circumference). Ascending aortic plaque composition was evaluated based on CT densities expressed as Hounsfield units (HU). TECABs using the Da Vinci telemanipulator were performed either on the arrested heart (n = 39) with an intra-aortic cardiopulmonary bypass (CPB) perfusion device or on the beating heart (n = 6) in patients with severe atherosclerosis.</p><p><b>Results.</b> The presence of mild atherosclerosis at the ascending aorta (11/39) was associated with intra-aortic CPB perfusion device-related difficulties such as intra-aortic balloon migration (BM) or balloon rupture (<i>P</i> = .007) in arrested heart TECABs. The CT density of atherosclerotic plaque in patients with BM was mean 58 HU ± 51 standard deviation (SD), suggesting noncalcifying plaque. In patients without BM, CT density of plaque was mean 526 HU ± 306 SD corresponding to calcifying plaque (<i>P</i> < .001). Balloon rupture occurred in 2 patients who had calcifying plaque at the ascending aorta.</p><p><b>Conclusion.</b> Evaluation of ascending aortic atherosclerosis with 16-MDCT angiography is useful prior to TECAB surgery. Even mild atherosclerosis of the ascending aorta is associated with intraoperative difficulties regarding the remote-access perfusion system that is used for arrested heart TECAB surgery.</p> ER -