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An Argument for Routine Ultrasound Screening of the Thoracic Aorta in the Cardiac Surgery Population

Department of Anesthesia, Emory University Hospital, Atlanta, Georgia, wswhitl{at}emory.edu

Kathryn E. Glas, MD, MBA, FASE

Department of Anesthesia, Emory University Hospital, Atlanta, Georgia

Stroke and neurological injury are among the most devastating and disabling complications associated with cardiac surgery. Transesophageal echocardiography and epiaortic ultrasound allow for sensitive, point-of-care diagnosis of thoracic aortic disease, which is especially common in patients with heart disease. Unlike other operative procedures, the manipulation of the ascending aorta is routine in cardiac surgery and often unavoidable. Dislodgement and embolization from the ascending and aortic arch atheromas have been clearly associated with manipulation during cardiac surgery. Epiaortic ultrasound and transesophageal echocardiography screening are more accurate and more accessible to the operative team than any other available modality to diagnose atherosclerosis of the aorta. The goal of this review is to review the rationale and scientific evidence that suggests that the routine use of ultrasound guidance in cardiac surgery may improve postoperative outcomes in this patient population.

Key Words: aortic atherosclerosis • stroke • cardiac surgery • epiaortic ultrasound

This version was published on December 1, 2008

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 12, No. 4, 290-297 (2008)
DOI: 10.1177/1089253208328583


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