This Article Full Text (PDF) All Versions of this Article: 0003319708325446v1 60/5/633    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Zayed, H. Articles by Rashid, H. PubMed PubMed Citation Articles by Zayed, H. Articles by Rashid, H. Pubmed/NCBI databases Medline Plus Health Information Heart Valve Diseases Social Bookmarking                         What's this?

Selective Screening for Asymptomatic Carotid Artery Disease Prior to Isolated Heart Valve Surgery

King's College Hospital, Denmark Hill, London

Ahmad Ali, MSc, FRCS

King's College Hospital, Denmark Hill, London

Olaf Wendler, MD, PhD, FRCS

King's College Hospital, Denmark Hill, London

Hisham Rashid, MSc, FRCS

King's College Hospital, Denmark Hill, London, hisham.rashid{at}kch.nhs.uk

Objective: To assess the yield of screening for asymptomatic carotid artery disease prior to isolated heart valve surgery (IHVS).

Methods: Retrospective analysis of the preoperative carotid duplex scans performed in neurologically asymptomatic patients who underwent IHVS between 2003 and 2006 was performed. Internal carotid artery (ICA) stenosis of 70% was considered significant. Patients with concomitant coronary artery disease were excluded.

Results: A total of 177 patients underwent IHVS (one valve in 165 and 2 valves in 12 patients). No or minor ICA disease detected in 172 patients. Four patients (2.25%) had significant unilateral ICA stenosis and 1 patient (0.56%) had unilateral ICA occlusion. Three patients (1.69%) suffered postoperative stroke, while 2 patients (1.1%) suffered transient ischemic attacks. All neurologically affected patients had normal preoperative carotid duplex. The in-hospital mortality was 4.5%.

Conclusion: Prevalence of significant ICA disease is low in patients undergoing IHVS. This population does not benefit from preoperative carotid screening.

Key Words: Heart valve surgery • carotid screening • carotid artery stenosis and carotid endarterectomy

This version was published on October 1, 2009

Angiology, Vol. 60, No. 5, 633-636 (2009)
DOI: 10.1177/0003319708325446


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?