Assessment of ascending aorta using epiaortic ultrasonography during off-pump coronary artery bypass grafting

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Published on: November 24, 2014

Tomoki Shimokawa1, Naoki Minato, Noriko Yamada

  • 1Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, Kasuga City, Fukuoka, Japan. tshimokawa-circ@umin.ac.jp

The Annals of Thoracic Surgery
|March 20, 2003
PubMed

Insights

Epiaortic ultrasonography identified aortic atherosclerosis in 35% of patients undergoing off-pump coronary artery bypass. This highlights the need for revascularization without aortic manipulation in approximately 25% of these patients.

Area of Science:

  • Cardiovascular Surgery
  • Diagnostic Imaging
  • Vascular Ultrasound

Background:

  • Off-pump coronary artery bypass (OPCAB) carries risks with aortic clamping.
  • Ascending aorta management is crucial during OPCAB.

Purpose of the Study:

  • To assess ascending aorta management using epiaortic ultrasonography during OPCAB.
  • To identify patients requiring alternative revascularization strategies.

Main Methods:

  • Intraoperative epiaortic ultrasonography (10-MHz probe) in 155 OPCAB patients (Aug 1999-Jul 2001).
  • Analysis of ultrasonography findings, surgical modifications, and outcomes.
  • Categorization into groups based on anterior ascending aorta atherosclerosis.

Main Results:

  • Atherosclerotic findings in the anterior ascending aorta occurred in 34.8% of patients (Group A).
  • In Group A, 24.8% underwent graft modification without clamping; 11.1% had clamp site modification.
  • No clamp-related cerebral infarctions or deaths; one aortic dissection in the non-atherosclerotic group.

Conclusions:

  • Epiaortic ultrasonography revealed anterior ascending aorta atherosclerosis in 35% of OPCAB patients.
  • Revascularization without aortic manipulation is indicated for approximately 25% of OPCAB patients.
  • Preoperative identification of aortic disease can guide surgical strategy to minimize complications.
Abstract

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