Journal of Cardiothoracic and Vascular Anesthesia
Volume 21, Issue 6 , Pages 805-809 , December 2007

An Intraoperative Assessment of the Ascending Aorta: A Comparison of Digital Palpation, Transesophageal Echocardiography, and Epiaortic Ultrasonography

  • Sujeeth Suvarna, FRCSI

      Affiliations

    • Department of Cardiothoracic Surgery The Heart & UCL Hospitals, London, United Kingdom
    • ,
  • Andrew Smith, FRCA

      Affiliations

    • Department of Anaesthesia, The Heart & UCL Hospitals, London, United Kingdom
    • ,
  • Jan Stygall, MSc

      Affiliations

    • Centre for Behavioural and Social Sciences in Medicine, UCL, London, United Kingdom
    • Thames Valley University, London, United Kingdom.
    • ,
  • Shyam Kolvecar, MS, FRCS(CTh)

      Affiliations

    • Department of Cardiothoracic Surgery The Heart & UCL Hospitals, London, United Kingdom
    • ,
  • Robin Walesby, FRCS

      Affiliations

    • Department of Cardiothoracic Surgery The Heart & UCL Hospitals, London, United Kingdom
    • ,
  • Michael Harrison, FRCP

      Affiliations

    • Centre for Behavioural and Social Sciences in Medicine, UCL, London, United Kingdom
    • ,
  • Stanton Newman, DPhil, Dip Psych, AFBPS, MRCP(Hon)

      Affiliations

    • Centre for Behavioural and Social Sciences in Medicine, UCL, London, United Kingdom
    • Corresponding Author InformationAddress reprint requests to Stanton Newman, DPhil, Centre for Behavioural and Social Sciences in Medicine, University College London, Room 120, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, United Kingdom.

References 

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  3. Wareing TH, Davila-Roman VG, Barzilai B, et al. Management of the severely atherosclerotic ascending aorta during cardiac operations. J Thorac Cardiovasc Surg. 1992;103:453–462
  4. Davila-Roman VG, Phillips KJ, Daily BB, et al. Intraoperative transesophageal echocardiography and epiaortic ultrasound for assessment of atherosclerosis of the thoracic aorta. J Am Coll Cardiol. 1996;28:942–947
  5. Bolotin G, Domany Y, De Perini L, et al. Use of intraoperative epiaortic ultrasonography to delineate aortic atheroma. Chest. 2005;127:60–65
  6. Amarenco P, Cohen H, Tzourio C, et al. Atherosclerotic disease of the aortic arch and the risk of ischemic stroke. N Engl J Med. 1994;331:1474–1479
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  12. Ribakove GH, Katz ES, Galloway AC, et al. Surgical implication of transesophageal echocardiography to grade the atheromatous aortic arch. Ann Thorac Surg. 1993;53:758–763
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  15. Tunick PA, Kronzon I. Atheromas of the thoracic aorta: Clinical and therapeutic update. J Am Coll Cardiol. 2000;35:545–554
  16. The French Study of Aortic Plaques in Stroke Group. Atherosclerotic disease of the aortic arch as a risk factor for recurrent ischemic stroke. N Engl J Med. 1996;334:1216–1221
  17. Schachner T, Nagele G, Kacani A, et al. Factors associated with presence of ascending aortic atherosclerosis in CABS patients. Ann Thorac Surg. 2004;78:2028–2032
  18. van der Linden J, Hadijinikolaou L, Bergman P, et al. Postoperative stroke in cardiac operation is related to the location and extent of atherosclerotic disease in the ascending aorta. J Am Coll Cardiol. 2001;38:131–135
  19. Konstadt S, Reich D, Quintana C, et al. The ascending aorta: How much does transesophageal echocardiography see?. Anesth Analg. 1994;78:240–244
  20. Konstadt SN, Reich DL, Kahn R, et al. Transesophageal echocardiography can be used to screen for ascending aortic atherosclerosis. Anesth Analg. 1995;81:225–228
  21. Gold JP, Torres KE, Maldarelli W, et al. Improving outcomes in coronary surgery: The impact of echo-directed aortic cannulation and perioperative hemodynamic management in 500 patients. Ann Thorac Surg. 2004;78:1579–1585
  22. 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. J Cardiothorac Vasc Anesth. 1997;11:704–707
  23. Bergman P, van der Linden J, Forsberg K, et al. Preoperative computed tomography or intraoperative epiaortic ultrasound for the diagnosis of atherosclerosis of the ascending aorta?. Heart Surg Forum. 2004;7:E245–E249
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PII: S1053-0770(07)00169-3

doi: 10.1053/j.jvca.2007.05.014

Journal of Cardiothoracic and Vascular Anesthesia
Volume 21, Issue 6 , Pages 805-809 , December 2007

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