OBJECTIVE: Use of epiaortic scanning in coronary surgery is still a matter of debate. It is unclear whether the findings obtained by epiaortic scanning lead to effective changes in surgical technique that may reduce @entity64 rates. METHODS: Epiaortic scanning was performed in 352 @entity1 undergoing primary coronary artery bypass grafting before opening the pericardium using a 7.5-MHz ultrasonic probe. In the presence of moderate @entity731 (maximum aortic wall thickness of 3 to 5 mm), primarily single aortic crossclamping was carried out. In cases of severe @entity1463 (maximum aortic wall thickness > 5 mm), aortic no-touch techniques on the beating heart were used. RESULTS: The degree of ascending @entity731 was normal or mild in 151 @entity1 (42.9%), moderate in 167 @entity1 (47.5%), and severe in 34 @entity1 (9.6%). The operative technique was modified in 31.1% of @entity1 with moderate @entity2333 and in 91.2% of @entity1 with severe @entity2333 . Perioperative mortality was 0.0% for mild disease, 3.0% for moderate disease, and 8.8% for severe disease (P =.005). Corresponding @entity64 rates reached 2.0%, 2.4%, and 2.9% (P =.935). Logistic regression adjusting for EuroSCORE showed that ascending @entity731 was an independent predictor of perioperative mortality (P =.013, odds ratio 1.67, confidence interval 1.11-2.50). The influence of aortic disease on the @entity64 prevalence was probably due to chance (P =.935), demonstrating a potentially positive effect of operative modifications concerning @entity64 caused by aortic manipulation. CONCLUSIONS: We conclude that intraoperative screening of coronary artery bypass grafting @entity1 by epiaortic scanning can reveal useful information about the operative risk and with an aortic no-touch concept, perioperative @entity64 rates in high-risk @entity1 may be lower than predicted.

Modification of surgical technique for ascending @entity731 : impact on XXXX reduction in coronary artery bypass grafting.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity1463 :: ('MESH:D012598', 'Disease') :: ['sclerosis'] @entity2333 :: ('MESH:D001018', 'Disease') :: ['aortic sclerosis'] @entity731 :: ('MESH:D050197', 'Disease') :: ['atherosclerosis', 'aortic atherosclerosis']
@entity64 :: (MESH:D020521,Disease) :: ['stroke']
