A standardised intraoperative ultrasound examination of the aorta and proximal coronary arteries.

The aim of this study was to describe a standardised intraoperative ultrasound examination of the aorta and proximal coronary arteries for use in cardiac surgery using a handheld probe, to be used in conjunction with intraoperative transoesophageal echocardiography. Most cardiac surgery operations involving the use of cardiopulmonary bypass will result in significant manipulation of the ascending aorta with potential atheroma dislodgement which may result in atheroembolism. Accurate detection and localisation of aortic atheroma allows the surgeon to adjust the site of aortic manipulation and potentially avoid dislodging atheroma. A single surgeon experience from 1996 to 2005 of 1455 intraoperative ultrasound examinations. Coronary surgery 1214, valve surgery 369, aortic surgery 30, congenital surgery 74 and reoperations 105. Stroke 13, TIA 2, confusion 56, coma 24 h 8. In 591, ultrasound data were recorded in a custom database. Age 66+/-0.5 (25-93) years, 69% males and coronary surgery 77%. Atheroma increased with distance from the aortic valve (P<0.001), and with age, (P<0.001). One third of patients more than 70 years had moderate or severe atheroma detected in the regions imaged by this technique. A standardised intraoperative ultrasound examination of the aorta and proximal coronary arteries is described.