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The Annals of Thoracic Surgery, Vol 50, 539-542, Copyright © 1990 by The Society of Thoracic Surgeons
H Ohteki, T Itoh, M Natsuaki, N Minato and H Suda
In an attempt to locate any atherosclerotic lesion in the ascending aorta
and to prevent embolization, intraoperative B-mode ultrasonography was
performed in 100 patients with ischemic heart disease (31 women and 69
men). Ultrasonography was carried out with a 10-MHz probe placed directly
on the ascending aorta. Ultrasonic imaging demonstrated an atherosclerotic
lesion in the lower half of the aorta in 76 patients (76%), a lesion in the
upper half of the aorta in 89 patients (89%), and a lesion at the orifice
of the innominate artery in 99 patients (99%). Prospective palpation
identified an atherosclerotic lesion in 12 (25%) of 48 patients. Thoracic
computed tomography in 79 patients showed calcification in the lower half
of the aorta in 6 patients (7.6%) and in the upper half of the aorta in 11
(13.9%). Palpation and thoracic computed tomography underestimated the
frequency of atherosclerotic lesions. Intraoperative ultrasonography
accurately identified atherosclerotic disease. This technique allows the
surgeon to modify cannulation, aortic clamping, and operative technique to
reduce the risk of perioperative stroke due to embolization of
atherosclerotic debris from the ascending aorta.
ARTICLES
Intraoperative ultrasonic imaging of the ascending aorta in ischemic heart disease
Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Japan.
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