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수술중 경식도 심초음파로 대동맥궁의 유동성 죽상판이 발견된 관상동맥 우회술 환자의 마취 경험

Other Titles
 Management of a patient with atheromatous aortic arch diagnosed by a intraoperative transophageal echocardiography during coronary artery bypass grafting 
Authors
 정성미  ;  곽영란  ;  오영준  ;  이종화  ;  김수환  ;  홍용우 
Citation
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.42(3) : 398-402, 2002 
Journal Title
Journal of Korean Society of Anesthesiologist(대한마취과학회지)
ISSN
 0302-5780 
Issue Date
2002
Keywords
Atheromatous aorta ; coronary artery bypass graft ; transesophageal echocardiography
Abstract
Protruding atheromas of the aorta have been identified as one of the sources of a systemic emboli and a major cause of stroke following cardiac surgery. We report a case of surgical modification in a 58-year-old man with an atheromatous aortic arch detected by an intraoperative transesophageal echocardiography (TEE) during coronary artery bypass grafting (CABG).

After induction of anesthesia, protruding atheromatous plaques with a mobile element in the aortic arch were identified by a TEE that was not noticed by a preoperative angiography and transthoracic echocardiograpy. Based on the TEE finding, the surgical technique was modified to CABG combined with an aortic atherectomy under deep hypothermic circulatory arrest. The atheromatous areas correlated well with the TEE finding and the patient recovered from anesthesia and surgery without neurologic deficit.

Therefore, an intraoperative TEE examination is considered as a safe and reliable technique to identify atherosclerotic disease of the thoracic aorta in patients undergoing CABG and to minimize unexpected neurologic complications after CABG.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/143823
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