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

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…850 Intraoperative assessment of the ascending aorta for detection of plaque by epiaortic ultrasound imaging is superior to direct palpation and TEE. 851 Because the presence of extracranial disease of the internal carotid artery is a risk factor for adverse neurological events after CABG, 860 one might argue for use of carotid noninvasive scanning (duplex ultrasonography or noninvasive carotid screening) in all patients scheduled for CABG. At issue is the effectiveness of noninvasive carotid screening in identifying carotid artery stenoses of hemodynamic significance.…”

Multimodality Imaging of Diseases of the Thoracic Aorta in Adults: From the American Society of Echocardiography and the European Association of Cardiovascular Imaging

“…368,375,376 Its high sensitivity and excellent reproducibility make it a clinically useful tool. 377 Compared with TEE, EAU has better resolution, less artifact, no blind spot, and superior detection of disease in the mid and distal ascending aorta. Moreover, EAU also appears to be superior to preoperative CT for this purpose.…”

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…5 Identification of an atherosclerotic aorta is believed to be an important step in reducing the risk of stroke after CABG (850). Intraoperative assessment of the ascending aorta for detection of plaque by epiaortic ultrasound imaging is superior to direct palpation and TEE (851,852). Predictors of ascending aortic atherosclerosis include increasing age, hypertension, extracardiac atherosclerosis (peripheral artery and cerebrovascular disease), and elevated serum creatinine concentrations (853)(854)(855).…”