OBJECTIVE: The purpose of this study was to determine the relationship between the aortic atheromatous plaque echo density and the incidence of postoperative stroke or embolic events in patients undergoing on-pump coronary artery bypass grafting (CABG). PATIENTS AND METHODS: Three hundred and fourteen patients who received on-pump CABG alone were studied. Images of the aortic plaques obtained using transesophageal echocardiography were transferred to a computer. Using an image analysis program, a histogram for plaques more than 3 mm in thickness was obtained through the gray tone frequency distribution of the pixels (0-225). The gray scale median (GSM) was used as a measure of plaque echo density. RESULTS: Fifty-eight plaques in patients not associated with postoperative stroke or embolic events had GSM ranging from 58 to 241 (151.0+/-38.2), while 9 plaques in patients associated with stroke or embolic events had GSM ranging from 67 to 130 (90.6+/-21.3, p<0.001). The incidence of stroke or embolism was 58.3% when GSM of plaque was less than 100, while it was 3.6% when plaque GSM was more than 100 (p<0.001). CONCLUSION: This study indicated that computer analysis of aortic atheromatous plaque was useful for selecting patients who had a high risk of postoperative stroke or embolism when receiving on-pump CABG, and for decreasing the incidence of them.
OBJECTIVE: The purpose of this study was to determine the relationship between the aortic atheromatous plaque echo density and the incidence of postoperative stroke or embolic events in patients undergoing on-pump coronary artery bypass grafting (CABG). PATIENTS AND METHODS: Three hundred and fourteen patients who received on-pump CABG alone were studied. Images of the aortic plaques obtained using transesophageal echocardiography were transferred to a computer. Using an image analysis program, a histogram for plaques more than 3 mm in thickness was obtained through the gray tone frequency distribution of the pixels (0-225). The gray scale median (GSM) was used as a measure of plaque echo density. RESULTS: Fifty-eight plaques in patients not associated with postoperative stroke or embolic events had GSM ranging from 58 to 241 (151.0+/-38.2), while 9 plaques in patients associated with stroke or embolic events had GSM ranging from 67 to 130 (90.6+/-21.3, p<0.001). The incidence of stroke or embolism was 58.3% when GSM of plaque was less than 100, while it was 3.6% when plaque GSM was more than 100 (p<0.001). CONCLUSION: This study indicated that computer analysis of aortic atheromatous plaque was useful for selecting patients who had a high risk of postoperative stroke or embolism when receiving on-pump CABG, and for decreasing the incidence of them.
Authors: John T Denny; Enrique Pantin; Antonio Chiricolo; James Tse; Julia E Denny; Sagar S Mungekar; Darrick Chyu; Alann Solina Journal: J Clin Med Res Date: 2014-10-16