Does epiaortic ultrasound screening reduce perioperative stroke in patients undergoing coronary surgery? A topical...

Area of Science:

• Cardiovascular Surgery
• Neurology
• Medical Imaging

Background:

• Stroke is a significant concern in coronary artery bypass grafting (CABG) patients.
• Reducing post-CABG stroke incidence requires effective preventative strategies.
• Aortic assessment pre-surgery can mitigate stroke risk.

Purpose of the Study:

• To review evidence supporting routine epiaortic ultrasound scanning (EAS) in CABG.
• To identify barriers to EAS adoption and propose solutions.
• To advocate for EAS as a standard of care to decrease stroke rates.

Main Methods:

• Literature review of studies on aortic assessment and stroke prevention in CABG.
• Comparison of palpation, transesophageal echocardiography (TEE), and epiaortic ultrasound scanning (EAS) for aortic evaluation.
• Analysis of evidence for EAS's efficacy in reducing post-CABG stroke.

Main Results:

• Epiaortic ultrasound scanning (EAS) demonstrates superiority over palpation and TEE for intraoperative aortic assessment.
• EAS-guided surgical planning is associated with reduced stroke rates in CABG patients.
• Despite evidence, EAS is not widely implemented as a standard procedure.

Conclusions:

• Routine use of EAS in CABG patients is supported by evidence for stroke risk reduction.
• Overcoming barriers to EAS implementation is crucial for improving patient safety.
• Adopting EAS can enhance outcomes and decrease the incidence of post-CABG stroke.