HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Tomoki Shimokawa Naoki Minato Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shimokawa, T. Articles by Itoh, M. Search for Related Content PubMed PubMed Citation Articles by Shimokawa, T. Articles by Itoh, M. Related Collections Coronary disease

Ann Thorac Surg 2002;74:2097-2100
© 2002 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Assessment of ascending aorta using epiaortic ultrasonography during off-pump coronary artery bypass grafting

^a Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, Fukuoka, Japan

Accepted for publication July 23, 2002.

* Address reprint requests to Dr Shimokawa, Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, 4-5 Sukukita, Kasuga City Fukuoka 816-0864, Japan.
e-mail: tshimokawa-circ{at}umin.ac.jp

BACKGROUND: Use of an aortic partial clamp for proximal anastomosis during off-pump coronary artery bypass is known to increase the risk of fatal complications. The purpose of this study was to assess the management of the ascending aorta evaluated with epiaortic ultrasonography during off-pump coronary artery bypass.

METHODS: Intraoperative ultrasonography of the ascending aorta with a 10-MHz probe was performed consecutively in 155 patients undergoing off-pump coronary artery bypass between August 1999 and July 2001. The findings from ultrasonography, surgical modifications, and operative results were analyzed.

RESULTS: In 54 patients (34.8%), epiaortic ultrasonography showed atherosclerotic findings in the anterior side of the ascending aorta (group A). The remaining 101 patients had either normal findings or atherosclerotic findings in only the posterior side (group NA). A proximal anastomosis to the aorta was preoperatively planned in 117 patients (group A, 42; group NA, 75). In group A, a graft modification without clamping was implemented in 29 patients (24.8% of 117 patients), whereas the clamp site was modified to a different segment in 13 patients (11.1% of 117 patients). In all 75 patients in group NA, partial clamping was used in the standard fashion. There were no cerebral infarctions or operative deaths related to partial clamping. However, aortic dissection occurred in 1 patient in group NA.

CONCLUSIONS: In 35% of patients undergoing off-pump coronary artery bypass, epiaortic ultrasonography identified atherosclerotic findings in the anterior wall of the ascending aorta. This study suggests that revascularization without aortic manipulation during off-pump coronary artery bypass is indicated in as many as 25% of patients.

This article has been cited by other articles:

				Y.-L. Li, D. T. Wong, W. Wei, and J. Liu A novel acoustic window for trans-oesophageal echocardiography by using a saline-filled endotracheal balloon Br. J. Anaesth., November 1, 2006; 97(5): 624 - 629. [Abstract] [Full Text] [PDF]

				O. Lev-Ran, R. Braunstein, R. Sharony, A. Kramer, Y. Paz, R. Mohr, and G. Uretzky No-touch aorta off-pump coronary surgery: The effect on stroke J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 307 - 313. [Abstract] [Full Text] [PDF]

				S. Das and J. Dunning Can epiaortic ultrasound reduce the incidence of intraoperative stroke during cardiac surgery? Interactive CardioVascular and Thoracic Surgery, March 1, 2004; 3(1): 71 - 75. [Abstract] [Full Text] [PDF]