Best Practice & Research Clinical Anaesthesiology
Volume 23, Issue 3 , Pages 335-341 , September 2009

Epiaortic ultrasound assessment of the aorta in cardiac surgery

  • Alistair George Royse, MBBS, MD, FRACS, FCSANZ (Cardiothoracic Surgeon)

      Affiliations

    • Cardiovascular Therapeutics Unit, Department of Surgery and Pharmacology, University of Melbourne, VIC, Australia
    • The Royal Melbourne Hospital, VIC, Australia
    • Corresponding Author InformationCorresponding author. Level 8, Medical Building, Department of Pharmacology, University of Melbourne, Carlton, VIC 3010, Australia. Tel.: +61 3 8344 5673.
    • ,
  • Colin Forbes Royse, MBBS, MD, FANZCA (Cardiothoracic Anaesthetist)

      Affiliations

    • Anaesthesia and Pain Management Unit, Department of Pharmacology, University of Melbourne, VIC, Australia
    • The Royal Melbourne Hospital, VIC, Australia

References 

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  2. Biancari F, Mosorin M, Rasinaho E, et al. Postoperative stroke after off-pump versus on-pump coronary artery bypass surgery. The Journal of Thoracic and Cardiovascular Surgery. 2007;133(1):169–173
  3. Shroyer AL, Coombs LP, Peterson ED, et al. The Society of Thoracic Surgeons: 30-day operative mortality and morbidity risk models. The Annals of Thoracic Surgery. 2003;75(6):1856–1864[discussion 1864–5]
  4. Calafiore AM, Di Mauro M, Teodori G, et al. Impact of aortic manipulation on incidence of cerebrovascular accidents after surgical myocardial revascularization. The Annals of Thoracic Surgery. 2002;73(5):1387–1393
  5. Zamvar V, Williams D, Hall J, et al. Assessment of neurocognitive impairment after off-pump and on-pump techniques for coronary artery bypass graft surgery: prospective randomised controlled trial. BMJ. 2002;325(7375):1268
  6. Barbut D, Caplan LR. Brain complications of cardiac surgery. Current Problems in Cardiology. 1997;22(9):449–480
  7. Mahanna EP, Blumenthal JA, White WD, et al. Defining neuropsychological dysfunction after coronary artery bypass grafting. The Annals of Thoracic Surgery. 1996;61(5):1342–1347
  8. Hammon JW, Stump DA, Kon ND, et al. Risk factors and solutions for the development of neurobehavioral changes after coronary artery bypass grafting. The Annals of Thoracic Surgery. 1997;63(6):1613–1618
  9. Whitley WS, Glas KE. An argument for routine ultrasound screening of the thoracic aorta in the cardiac surgery population. Seminars in Cardiothoracic and Vascular Anesthesia. 2008;12(4):290–297
  10. Van Zaane B, Zuithoff NP, Reitsma JB, et al. Meta-analysis of the diagnostic accuracy of transesophageal echocardiography for assessment of atherosclerosis in the ascending aorta in patients undergoing cardiac surgery. Acta Anaesthesiologica Scandinavica. 2008;52(9):1179–1187
  11. Barbut D, Gold JP. Aortic atheromatosis and risks of cerebral embolization. Journal of Cardiothoracic and Vascular Anesthesia. 1996;10(1):24–29
  12. Hangler HB, Nagele G, Danzmayr M, et al. Modification of surgical technique for ascending aortic atherosclerosis: impact on stroke reduction in coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery. 2003;126(2):391–400
  13. Clark RE, Brillman J, Davis DA, et al. Microemboli during coronary artery bypass grafting. Genesis and effect on outcome. The Journal of Thoracic and Cardiovascular Surgery. 1995;109(2):249–257
  14. Sedrakyan A, Wu AW, Parashar A, et al. Off-pump surgery is associated with reduced occurrence of stroke and other morbidity as compared with traditional coronary artery bypass grafting: a meta-analysis of systematically reviewed trials. Stroke. 2006;37(11):2759–2769
  15. Abraham R, Karamanoukian HL, Jajkowski MR, et al. Does avoidance of cardiopulmonary bypass decrease the incidence of stroke in diabetics undergoing coronary surgery?. The Heart Surgery Forum. 2001;4(2):135–140
  16. van Dijk D, Spoor M, Hijman R, et al. Cognitive and cardiac outcomes 5 years after off-pump vs on-pump coronary artery bypass graft surgery. JAMA : The Journal of the American Medical Association. 2007;297(7):701–708
  17. van der Heijden GJ, Nathoe HM, Jansen EW, Grobbee DE. Meta-analysis on the effect of off-pump coronary bypass surgery. European Journal of Cardio-Thoracic Surgery. 2004;26(1):81–84
  18. Lev-Ran O, Braunstein R, Sharony R, et al. No-touch aorta off-pump coronary surgery: the effect on stroke. The Journal of Thoracic and Cardiovascular Surgery. 2005;129(2):307–313
  19. Royse AG, Royse CF, Ajani AE, et al. Reduced neuropsychological dysfunction using epiaortic echocardiography and the exclusive Y graft. The Annals of Thoracic Surgery. 2000;69(5):1431–1438
  20. Suvarna S, Smith A, Stygall J, et al. An intraoperative assessment of the ascending aorta: a comparison of digital palpation, transesophageal echocardiography, and epiaortic ultrasonography. Journal of Cardiothoracic and Vascular Anesthesia. 2007;21(6):805–809
  21. Zingone B, Rauber E, Gatti G, et al. The impact of epiaortic ultrasonographic scanning on the risk of perioperative stroke. European Journal of Cardio-Thoracic Surgery. 2006;29(5):720–728
  22. Wilson MJ, Boyd SY, Lisagor PG, et al. Ascending aortic atheroma assessed intraoperatively by epiaortic and transesophageal echocardiography. The Annals of Thoracic Surgery. 2000;70(1):25–30
  23. Sylivris S, Calafiore P, Matalanis G, et al. The intraoperative assessment of ascending aortic atheroma: epiaortic imaging is superior to both transesophageal echocardiography and direct palpation. Journal of Cardiothoracic and Vascular Anesthesia. 1997;11(6):704–707
  24. Royse A, Royse C. A standardised intraoperative ultrasound examination of the aorta and proximal coronary arteries. Interactive Cardiovascular and Thoracic Surgery. 2006;5:701–704
  25. Royse C, Royse A, Blake D, Grigg L. Screening the thoracic aorta for atheroma: a comparison of manual palpation, transesophageal and epiaortic ultrasonography. Annals of Thoracic and Cardiovascular Surgery. 1998;4:347–350
  26. Royse C, Royse A, Blake D, Grigg L. Assessment of thoracic aortic atheroma by echocardiography: a new classification and estimation of risk of dislodging atheroma during three surgical techniques. Annals of Thoracic and Cardiovascular Surgery. 1998;4(2):72–77
  27. Royse AG, Royse CF, Raman JS. Exclusive Y graft operation for multivessel coronary revascularization. The Annals of Thoracic Surgery. 1999;68(5):1612–1618
  28. Kouchoukos NT, Wareing TH, Daily BB, Murphy SF. Management of the severely atherosclerotic aorta during cardiac operations. Journal of Cardiac Surgery. 1994;9(5):490–494

PII: S1521-6896(09)00019-6

doi: 10.1016/j.bpa.2009.02.005

Best Practice & Research Clinical Anaesthesiology
Volume 23, Issue 3 , Pages 335-341 , September 2009

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