Document Detail

Assessment of ascending aorta using epiaortic ultrasonography during off-pump coronary artery bypass grafting.
MedLine Citation:
PMID:  12643401     Owner:  NLM     Status:  MEDLINE    
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.
Tomoki Shimokawa; Naoki Minato; Noriko Yamada; Yuji Takeda; Yasushi Hisamatsu; Manabu Itoh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  74     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-03-19     Completed Date:  2003-04-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2097-100     Citation Subset:  AIM; IM    
Department of Thoracic and Cardiovascular Surgery, Fukuoka Tokushukai Hospital, Kasuga City, Fukuoka, Japan.
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MeSH Terms
Aged, 80 and over
Aneurysm, Dissecting / etiology
Aorta / ultrasonography*
Aortic Diseases
Arteriosclerosis / ultrasonography
Coronary Artery Bypass / methods*
Middle Aged

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