Purpose: Severe aortic calcification may complicate or even preclude cannulation of the ascending aorta, cross clamping, and insertion of bypass grafts. We set out to determine the incidence of aortic calcifications and to define predictors of operative complications. Methods: In a prospective evaluation of 100 consecutive candidates for open-heart surgery, we checked the pa and lateral chest radiographs for 11 indicators of aortic calcification. Patients with severe calcification were referred for spiral computed tomography (CT) with 3-dimensional reconstruction of aortic calcifications and echocardiography. Results: Evidence of aortic calcification was found in 70 patients (70%). In 4 patients, intraoperative complications due to aortic calcification were encountered. In one patient, surgery could not be completed. All 4 patients displayed linear calcifications of the ascending aorta on the lateral chest film. In another patient with CT proof of a completely calcified ascending aorta, aortic valve replacement was not attempted. In patients without linear calcifications of the ascending aorta, cardiopulmonary bypass could be instituted without problems. Radiographic features on the pa film were less sensitive and not specific for intraoperative complications. Echocardiography detected the lesion in 4/5 cases of severe calcification, but underestimated the extent of disease in 3 patients. CT predicted the intraoperative findings accurately in all 5 cases. Conclusions: Linear calcification of the ascending aorta on lateral chest radiographs is a both sensitive and specific predictor of intraoperative complications. 3D spiral CT facilitates surgical planning in such patients. Careful preoperative screening may help to avoid exposing inoperable patients to the risk of thoracotomy.
|Translated title of the contribution||Preoperative screening for aortic calcification in cardiac surgery candidates|
|Number of pages||9|
|Journal||Zeitschrift fur Herz-, Thorax- und Gefasschirurgie|
|State||Published - 1998|
- Cardiac surgery
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine