Imaging of the distal ascending aorta using modified transesophageal echocardiography in cardiac surgery

摘要: Epiaortic ultrasound scanning of the ascending aorta is a safe and useful method to detect atherosclerosis in patients undergoing cardiac surgery. The use epiaortic can lead modifications surgical technique, which effectively reduces post-operative incidence stroke case severe atherosclerosis. considered ‘gold’ standard for detecting aorta. However, only be applied after sternotomy. If then appears more than anticipated, decisions regarding changes strategy have made at relatively late stage. Transesophageal echocardiography widely used imaging modality permitting evaluation extent thoracic assessment distal using transesophageal disturbed by interposition air-filled trachea between oesophagus Recently A-View was introduced as modification conventional with aim overcome this limitation. An intra-tracheal balloon filled saline replaces air trachea. Hence, it becomes possible assess presence severity before It acknowledged that scientific diagnostic device phased approach should followed. After technical development safety evaluation, but investigating whether test may replace current techniques actually improves (cost)-effectiveness terms patient outcome, test’s reproducibility potential discriminative accuracy must quantified. This thesis describes process method. In cross-sectional study surgery we showed visible all patients. There were no clinical important side effects associated catheter. subsequent performed larger positive predictive value 67%, negative 97%. Sensitivity 95% specificity 79%. Therefore yields adequate To images, obtained method, reviewed 4 different observers two moments. agreement across slight moderate within substantial. We further investigate how improve enhance applicability Finally cost-effectiveness modeling A-view adjustment procedure based on findings likely reduce health care costs increase benefits compared strategy. offers minimally invasive image guide Future research needed indeed leads therapeutic management reduction embolic events stroke.