| Japanese |
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| Title | 経食道心エコー図による胸部大動脈の動脈硬化病変の評価はCABG術後脳神経障害を予防できるか? |
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| Subtitle | |
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| Authors | 藤井美江*, 野村実*, 鈴木英弘* |
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| Organization | *東京女子医科大学麻酔科学教室 |
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| Journal | 循環制御 |
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| Volume | 20 |
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| Number | 2 |
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| Page | 192-198 |
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| Year/Month | 1999/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」冠状動脈再建術症例49例を対象に, 胸部大動脈の動脈硬化病変を評価した. 経食道心エコー図(TEE)で重度病変を認めた22例(45%)を重度群とした. 動脈硬化の術前危険因子は軽度群と重度群間に有意差なく, 胸部レントゲン写真の石灰化所見はTEEと比較して感度は21%, 特異度は82%であった. 重度群の1例(4%)が術後脳梗塞を発症したが, 軽度群では脳神経障害を発症しなかった. Epiaortaechocardiography(EAE)を併用した8例中2例で, TEEで捉えられなかった重度病変が検出された. 術前危険因子やレントゲン写真による動脈硬化の重症度の予測は難しいが, TEEやEAEによる動脈硬化病変の評価は脳神経障害の予防に有用であることが示唆された. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Can the Assessment of Severe Atherosclerosis Using Transesophageal Echocardiography Predict Neurological Complications during CABG Surgery? |
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| Authors | Yoshie Fujii*, Minoru Nomura*, Hidehiro Suzuki* |
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| Organization | *Department of Anesthesiology, School of Medicine, Tokyo Women's Medical University |
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| Journal | Circulation Control |
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| Volume | 20 |
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| Number | 2 |
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| Page | 192-198 |
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| Year/Month | 1999/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | It is important to change a surgical technique depending on atheromatous lesions, because severe atherosclerosis causes neurological disorders during and after cardiac surgery. We examined atherosclerosis in the thoracic aorta using transesophageal echocardiography (TEE) in 49 patients undergoing scheduled coronary artery bypass grafting (CABG) surgery. Severity of atherosclerosis was defined as follows : grade 0 ; normal, grade I ; intimal thicking over 3 mm, grade II ; plaque less than 5 mm, grade III ; plaque over 5 mm, and grade IV ; mobile plaque. TEE examination showed mild and severe atherosclerosis in 27 (55%) and 22 (45%) patients. However, preoperative risk factors and chest X-ray examination showed poor correlation with severity of atherosclerosis. One of 22 patients with severe atheromatous lesions (grade III) suffered. from cerebral infarction, whereas the patients with mild atherosclerosis developed no neurological complication. Careful examinations with epiaortaechocardiography (EAE) showed mobile plaque in 2 of 8 patients after TEE findings. |
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| Practice | Basic medicine |
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| Keywords | TEE, Atherosclerosis, Neurological complication, CABG surgery |
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