Korean J Thorac Cardiovasc Surg 2019; 52(2): 112-115  https://doi.org/10.5090/kjtcs.2019.52.2.112
Aortic Arch Endarterectomy Associated with On-Pump Cardiac Surgery in Patients with a Mobile Arch Atheroma
Joon Young Song , M.D.1,2, Jong Bum Choi , M.D.1,2, Jong Hun Kim , M.D.1,2, Kyung Hwa Kim , M.D.1,2, Tae Yun Kim , M.D.1,2
1Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, Jeonju, Korea; 2Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
Corresponding author: Tae Yun Kim, Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea,
(Tel) 82-63-250-1486 (Fax) 82-63-250-1480 (E-mail) uadocjon1314@hanmail.net
Received: July 12, 2018; Revised: October 3, 2018; Accepted: October 16, 2018.; Published online: April 5, 2019.
© The Korean Journal of Thoracic and Cardiovascular Surgery. All rights reserved.

cc This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
We describe aortic arch endarterectomy performed concomitantly with on-pump cardiac surgery in 2 patients with grade V arch atherosclerosis. In both patients, transesophageal echocardiographic findings led to the diagnosis of severe arch atherosclerosis associated with a mobile atheromatous plaque in the aortic arch. The severe arch atherosclerosis was managed with endarterectomy under deep hypothermic circulatory arrest. In patients with severe grade V atherosclerosis in the aortic arch, performing endarterectomy simultaneously with primary cardiac surgery may be justified as a way to reduce the risk of peripheral embolism, including cerebrovascular accidents, with minimal additional surgical risk.
Keywords: Aorta, Atherosclerosis, Embolism, Endarterectomy, Circulatory arrest


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