title: Intraoperative epiaortic scanning for preventing early stroke after off-pump coronary artery bypass.
abstract: BACKGROUND
  Numerous studies have demonstrated the accuracy of epiaortic ultrasound scanning (EAS) for assessing ascending aortic disease. It remains unclear whether EAS changes the incidence of perioperative stroke after off-pump coronary artery bypass (OPCAB).
  
  
  METHODS
  We studied a retrospective cohort of 2292 patients who underwent isolated OPCAB from January 2001 to December 2011. Patients were retrospectively subdivided into two groups: the non-EAS group (n=1019) who underwent OPCAB under only intraoperative transoesophageal echocardiography and the EAS group (n=1273) who underwent OPCAB under EAS.
  
  
  RESULTS
  In the non-EAS group, 317 (31.1%) patients underwent OPCAB with partial aortic clamping and 702 (68.9%) underwent OPCAB without partial aorta clamping. In the EAS group, 301 (23.7%) patients underwent OPCAB with partial aortic clamping and 972 (76.3%) underwent OPCAB without partial aortic clamping. The incidence of early stroke was not different statistically between the EAS and non-EAS groups [non-EAS 1.7% (17/1019) vs EAS 0.8% (10/1273); P=0.052]. However, in the subgroups of patients with partial aorta clamping, the incidence of the early stroke was significantly lower in the EAS group [2.8% (9/317) vs 0.7% (2/301) P=0.041].
  
  
  CONCLUSIONS
  EAS has a significant clinical benefit in reducing the incidence of early stroke in cases of partial aortic clamping in OPCAB. Therefore, EAS should be considered in patients who need partial aortic clamping in OPCAB.
authors.affiliation: Division of Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, 250 Seongsanno, Seodaemun-gu, Seoul120-752, Korea.
authors.forename: H-C
authors.initials: HC
authors.lastname: Joo
authors.forename: Y-N
authors.initials: YN
authors.lastname: Youn
authors.forename: Y-L
authors.initials: YL
authors.lastname: Kwak
authors.forename: G-J
authors.initials: GJ
authors.lastname: Yi
authors.forename: K-J
authors.initials: KJ
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003250:Constriction; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*
keywords: coronary artery bypass; early stroke; echocardiography; epiaortic scanning; monitoring; stroke