Sigrid E Sandner1, Richard Nolz2, Christian Loewe2, Mariella Gregorich3, Georg Heinze3, Martin Andreas1, Philippe Kolh4, Daniel Zimpfer1, Guenther Laufer1. 1. Division of Cardiac Surgery, Department of Surgery, Medical University Vienna, Vienna, Austria. 2. Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria. 3. Center for Medical Statistics, Informatics and Intelligent Systems, Clinical Biometrics Section, Medical University Vienna, Vienna, Austria. 4. Department of Biomedical and Preclinical Sciences, University of Liege, Liege, Belgium.
Abstract
OBJECTIVES: The aim of this study was to determine stroke rates in patients who did or did not undergo routine computed tomography angiography (CTA) aortic imaging before isolated coronary artery bypass grafting (CABG). METHODS: We conducted a retrospective analysis of a prospectively maintained single-centre registry. Between 2009 and 2016, a total of 2320 consecutive patients who underwent isolated CABG at our institution were identified. Propensity score matching was used to create a paired cohort of patients with similar baseline characteristics who did (CTA cohort) or did not (non-CTA cohort) undergo preoperative aortic CTA. The primary end point of the analysis was in-hospital stroke. RESULTS: In 435 propensity score-matched pairs, stroke occurred in 4 patients (0.92%) in the CTA cohort and in 14 patients (3.22%) in the non-CTA cohort (P = 0.017). Routine preoperative aortic CTA was associated with a significantly reduced risk of in-hospital stroke [relative risk 0.29, 95% confidence interval (CI) 0.09-0.86; P = 0.026; absolute risk reduction 2.3%, 95% CI 0.4-4.2; P = 0.017; number needed to treat = 44, 95% CI 24-242]. CONCLUSIONS: A preoperative screening for atheromatous aortic disease using CTA is associated with reduced risk of stroke after CABG. The routine use of preoperative aortic CTA could be applied so that surgical manipulation of the ascending aorta can be selectively reduced or avoided in patients with atheromatous aortic disease.
OBJECTIVES: The aim of this study was to determine stroke rates in patients who did or did not undergo routine computed tomography angiography (CTA) aortic imaging before isolated coronary artery bypass grafting (CABG). METHODS: We conducted a retrospective analysis of a prospectively maintained single-centre registry. Between 2009 and 2016, a total of 2320 consecutive patients who underwent isolated CABG at our institution were identified. Propensity score matching was used to create a paired cohort of patients with similar baseline characteristics who did (CTA cohort) or did not (non-CTA cohort) undergo preoperative aortic CTA. The primary end point of the analysis was in-hospital stroke. RESULTS: In 435 propensity score-matched pairs, stroke occurred in 4 patients (0.92%) in the CTA cohort and in 14 patients (3.22%) in the non-CTA cohort (P = 0.017). Routine preoperative aortic CTA was associated with a significantly reduced risk of in-hospital stroke [relative risk 0.29, 95% confidence interval (CI) 0.09-0.86; P = 0.026; absolute risk reduction 2.3%, 95% CI 0.4-4.2; P = 0.017; number needed to treat = 44, 95% CI 24-242]. CONCLUSIONS: A preoperative screening for atheromatous aortic disease using CTA is associated with reduced risk of stroke after CABG. The routine use of preoperative aortic CTA could be applied so that surgical manipulation of the ascending aorta can be selectively reduced or avoided in patients with atheromatous aortic disease.
Authors: Wiebe G Knol; Annemarie M den Harder; Linda M de Heer; Kálmán Benke; Pál Maurovich-Horvat; Tim Leiner; Béla Merkely; Gabriel P Krestin; Ad J J C Bogers; Ricardo P J Budde Journal: Eur Radiol Date: 2022-07-19 Impact factor: 7.034
Authors: Wiebe G Knol; Judit Simon; Annemarie M Den Harder; Margreet W A Bekker; Willem J L Suyker; Linda M de Heer; Pim A de Jong; Tim Leiner; Béla Merkely; Miklós Pólos; Gabriel P Krestin; Eric Boersma; Peter J Koudstaal; Pál Maurovich-Horvat; Ad J J C Bogers; Ricardo P J Budde Journal: Eur Radiol Date: 2021-11-16 Impact factor: 7.034
Authors: Ulrika Asenbaum; Richard Nolz; Stefan B Puchner; Tobias Schoster; Lukas Baumann; Julia Furtner; Daniel Zimpfer; Guenther Laufer; Christian Loewe; Sigrid E Sandner Journal: Sci Rep Date: 2020-08-17 Impact factor: 4.379