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. 2022 Jul 23;17(1):178.
doi: 10.1186/s13019-022-01927-2.

The routine use of preoperative non-contrast chest computerized tomography and carotid arteries Doppler prior to cardiac surgery

Ron Nates  1   2   3 , Mattan Arazi  3   4 , Liza Grosman-Rimon  1 , Roy Israel  1   5 , Jacob Gohari  3   6 , Leonid Sternik  1   4 , Erez Kachel  7   8   9
Affiliations

The routine use of preoperative non-contrast chest computerized tomography and carotid arteries Doppler prior to cardiac surgery

Ron Nates et al. J Cardiothorac Surg. .

Abstract

Introduction: There is no consensus as to which patients should undergo Non-Contrast Chest Computerized Tomography (NCCCT) and carotid arteries Doppler (CD) prior to cardiac surgery. The objective of this study was to examine whether preoperative imaging modalities provide clinical benefits and a change in surgical strategy.

Methods: We routinely performed NCCCT and CD in all non-urgent cardiac surgery patients. Major NCCCT/CD findings related to cardiovascular findings (aortic calcification/atherosclerosis, carotid artery plaque/stenosis), or other incidental findings (lung kidney, thyroid, adrenal, gastrointestinal sites etc.) were documented. The results were divided into 3 categories: (A) findings requiring both changes in surgical strategy and post-operative evaluation/treatment; (B) findings requiring changes in surgical strategy, but not requiring a specific post-operative evaluation/treatment; (C) findings not requiring changes in surgical strategy but requiring post-operative evaluation/treatment.

Results: In this cohort, 93 (18.6%) out of 500 patients had significant cardiac and extra-cardiac findings on NCCCT and/or CD. Among the 93 patients with significant findings, 33.33% (31 patients, 6.2% of all patients) were in group A, 7.5% (7 patients, 1.4% of all patients) were in group B, and 59.14% (55 patients, 11% of all patients) were in group C. Change in surgical strategies included, for example, switching from planned on-pump Coronary Artery Bypass Graft surgery (CABG) to off-pump CABG and performing additional procedures to the originally planned heart surgery.

Conclusion: Routine preoperative NCCCT and CD evaluation in all non-urgent cardiac surgical patients is an effective measure for uncovering cardiac and extra-cardiac findings prior to surgery.

Keywords: Cardiac surgery; Preoperative carotid arteries Doppler; Preoperative non-contrast chest computerized tomography; Unexpected findings.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Cardiac and extra-cardiac findings following routine preoperative imaging were divided into 3 categories: A findings requiring both changes in surgical strategy and post-operative evaluation/treatment; B findings requiring changes in surgical strategy, but not requiring a specific post-operative evaluation/treatment; C findings not requiring changes in surgical strategy but requiring post-operative evaluation/treatment
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