The utility of preoperative routine carotid artery duplex scanning in patients undergoing aortic valve replacement |
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Authors: | Thomas?T?Terramani Email author" target="_blank">Douglas?B?HoodEmail author Vincent?L?Rowe Christian?Peyre Ismael?N?Nuno Steven?G?Katz Roy?D?Kohl Vaughn?A?Starnes Fred?A?Weaver |
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Institution: | (1) Department of Surgery, Division of Vascular Surgery, University of Southern California, Keck School of Medicine, Los Angeles, CA, US;(2) Department of Cardiothoracic Surgery, University of Southern California, Keck School of Medicine, Los Angeles, CA, US |
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Abstract: | Patients with aortic valve disease (AVD) typically have a cardiac murmur that radiates to the neck and may be indistinguishable
from a cervical bruit secondary to carotid artery occlusive disease. The purpose of this report was to determine the prevalence
of significant asymptomatic carotid artery occlusive disease in patients undergoing aortic valve replacement (AVR). All patients
scheduled for AVR were prospectively studied. Preoperative carotid artery color-flow duplex was performed in all patients.
A total of 204 patients were included in the study and significant carotid disease (>50% stenosis of the internal carotid
artery) was found in 17 (8%). In patients with isolated aortic valve disease, 4/129 (3%) had significant stenosis. Of the
patients with concurrent aortic valve and coronary artery disease, 13/75 (17%) had significant stenosis. The incidence of
significant carotid stenosis in patients with aortic valve disease was over five fold higher in patients with concurrent coronary
artery disease (3% vs. 17%, p <0.001). The yield of routine carotid duplex scanning for patients undergoing isolated AVR is
low. However, in the subset of patients with concurrent coronary disease, the yield is higher. This finding supports the use
of routine carotid duplex scanning in patients with coexistent aortic valve and coronary artery disease. |
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