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Bad aorta

Kazuyoshi Tajima1

  • 1Department of Cardiovascular Surgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650, Japan, cvstaj@nagoya2.jrc.or.jp.

General Thoracic and Cardiovascular Surgery
|March 18, 2014
PubMed

Insights

Cardiac surgery for severe ascending aorta disease, termed "bad aorta," benefits from intraoperative epiaortic ultrasound. This imaging improves patient outcomes by guiding surgical approach and reducing risks.

Area of Science:

  • Cardiovascular Surgery
  • Medical Imaging

Background:

  • Cardiac surgery is increasingly performed on complex cases, including those with severe ascending aorta calcification ('bad aorta').
  • Preoperative non-enhanced CT scans show no correlation with intraoperative findings of aortic lesions.
  • Existing surgical techniques for 'bad aorta' have high mortality and cerebrovascular accident rates.

Purpose of the Study:

  • To evaluate the utility of intraoperative epiaortic ultrasound for assessing ascending aorta lesions in cardiac surgery.
  • To compare outcomes of different surgical management strategies for 'bad aorta' cases.

Main Methods:

  • Utilized intraoperative epiaortic ultrasound for real-time, high-quality aortic assessment.
  • Compared outcomes of traditional methods with a recent cross-clamping technique under short-term total circulatory arrest (TCA).

Main Results:

  • Intraoperative epiaortic ultrasound provides accurate aortic evaluations without significant patient burden.
  • The cross-clamping method with short-term total circulatory arrest (TCA) significantly reduced combined mortality and cerebrovascular accident rates to approximately 5% compared to previous methods (<10%).

Conclusions:

  • Intraoperative epiaortic ultrasound is a valuable tool for assessing sclerotic lesions in the ascending aorta during cardiac surgery.
  • Optimizing surgical procedures based on epiaortic ultrasound findings and employing techniques like short-term total circulatory arrest (TCA) can further improve outcomes for 'bad aorta' patients.

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