Epiaortic scanning for myocardial surgical revascularization

Abstract

Coronary artery bypass grafting may involve substantial manipulation of the ascending aorta, including aortic cannulation, antegrade cardioplegia line cannulation, and aortic clamping. These distortions of the ascending aorta can lead to disruption of soft or calcified plaques in the aortic wall, which can cause embolization. A relationship has been shown between the degree of aortic manipulation and the degree of cerebral embolization. Thus, it is clear that the risk of cerebral embolization can be reduced by alterations in the surgical technique. Such surgical alterations can be guided by epiaortic ultrasound by assisting the surgeon in identifying regions where atherosclerosis is present to avoid or minimize the degree of aortic manipulation in these regions. By using a previously published examination protocol, the atherosclerotic regions can be found more efficiently with an ultrasound examination than manual palpation, and the entire examination can be completed within 3-5 min. This review aims to outline the current evidence to support the use of epiaortic ultrasound for myocardial surgical revascularization.

Keywords

Atherosclerosis / cardiac surgical procedures / epiaortic / ultrasound

References

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