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Ann Thorac Surg 2000;70:1791
© 2000 The Society of Thoracic Surgeons

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Scientific abstract

Epiaortic scanning significantly alters surgical management during aortic instrumentation for cardiopulmonary bypass

Departments of Anesthesia and Surgery, University Hospital Campus-LHSC, University of Western Ontario, London, Ontario, Canada (Supported by funding from Medical Research Council grant MT13406)

Introduction. Epiaortic Doppler scanning can detect otherwise silent aortic atherosclerotic plaque. We assessed whether epiaortic scanning before aortic instrumentation would influence surgical management by altering cannulation, clamp, and anastamotic sites for patients undergoing coronary artery bypass (CAB) surgery.

Methods. After obtaining written informed consent, 102 patients undergoing CAB surgery were randomized to receive epiaortic scanning after manual palpation of the aorta and before aortic instrumentation. Surgical assessment of the aorta after palpation for siting of cannula, clamp, and anastamoses was compared with the assessment after epiaortic scanning.

Results. Epiaortic scanning exerted a significant influence on surgical management resulting in a change of siting for aortic instrumentation in 24% (24 of 102) of the patients.

Conclusions. Epiaortic scanning detects nonpalpable atherosclerosis and significantly alters surgical management.

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