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

Impact of Proximal Anastomosis Procedures on Stroke in Off‐Pump Coronary Artery Bypass Grafting

“…Therefore, the detection of atherosclerosis in the ascending aorta and a procedural modification to minimize aortic manipulation are essential to reduce the risk of stroke after CABG. Epiaortic ultrasonographic scanning is a widely established method to detect atherosclerosis in the aorta 2‐4 . A low stroke rate (2.3%) has been achieved using epiaortic scanning with on‐pump CABG followed by a procedural modification 5 …”

“…Therefore, a careful assessment of the ascending aorta and a judicious selection of operative procedure are essential for stroke prevention. Epiaortic ultrasonographic scanning is a widely established method to detect atherosclerotic changes in the aorta 2‐5 . We have modified the aortic anastomosis procedure using epiaortic ultrasonographic scanning.…”

“Anaortic” Off-Pump Coronary Artery Bypass Grafting Significantly Reduces Neurological Complications Compared to Off-Pump and Conventional On-Pump Surgery with Aortic Manipulation

“…The overall incidence of neurological complications in all operation groups was low and may be related to the epiaortic ultrasound, which is routinely performed at our institution. It is wellknown that epiaortic ultrasound is a useful tool to adjust the surgical strategy in cases with detected atherosclerosis of the ascending aorta [23][24][25]. However, the incidence of neurological complications could be reduced even further by performing "anaortic" techniques, thus offering the patient an equivalent treatment to the "gold standard" of CABG performed on-pump, but with less early mortality and with an additional reduction of the risk of neurological complications.…”

Causas incomuns de instabilidade hemodinâmica durante revascularização miocárdica sem circulação extracorpórea

“…Ultrasound evaluation of the aorta before clamping can reduce the incidence of neurologic complications. It has been estimated that 25% of patients undergoing MR without CB have some contraindication to aortic manipulation 8 . On the other hand, hemodynamic changes related with proximal anastomosis have been only poorly studied.…”