In a patient undergoing emergent CABG with an atherosclerotic aorta, what is the main risk of cross-clamping the aorta?

In patients undergoing emergent coronary artery bypass grafting (CABG) with an atherosclerotic aorta, the primary concern with cross-clamping the aorta is the risk of an embolic event. When the aorta is cross-clamped, any unstable atherosclerotic plaques or thrombi present in the aorta can dislodge due to the changes in hemodynamics and pressure. This dislodging can lead to emboli that may travel downstream, potentially occluding coronary vessels or peripheral arteries and causing significant complications, such as myocardial infarction or limb ischemia.

This risk is particularly heightened in patients with atherosclerotic changes, where plaque stability is compromised. Chance of this occurring necessitates careful consideration during surgical planning and technique. Therefore, understanding this risk is crucial for optimizing patient outcomes in cardiac surgery.

The other options do not directly address the immediate and critical consequence of cross-clamping the aorta in the context of atherosclerosis. While increased myocardial oxygen demand can occur during surgery, it is not the principal risk associated with the act of cross-clamping the aorta. Similarly, while prolonged cardiopulmonary bypass time can complicate surgery, it's the embolic risk that poses a more immediate danger following cross