Epicardial echocardiography: diagnostic utility for evaluating aortic valve disease during coronary surgery
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Updated: Sep 20, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Vlad E Frenk1, Stanton K Shernan, Holger K Eltzschig
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Abstract:
Intraoperative epicardial echocardiography is commonly used to evaluate the ascending aorta for atheromatous disease before cannulation and cross clamping. In addition, it may serve as a cardiac imaging technique in patients where placement of a transesophageal echocardiography (TEE) probe is contraindicated, probe advancement is difficult, or a TEE probe is not available. We report a patient who was taken to the OR for coronary artery bypass grafting. Intraoperative TEE was planned to evaluate aortic valve function. However, attempts to place a TEE probe were abandoned due to high resistance on probe insertion. Epicardial echocardiography revealed previously undiagnosed aortic valve disease resulting in replacement of this valve.
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