Meta‐analysis of the diagnostic accuracy of transesophageal echocardiography for assessment of atherosclerosis in the ascending aorta in patients undergoing cardiac surgery

摘要: Background: Stroke after cardiac surgery may be caused by emboli emerging from an atherosclerotic ascending aorta (AA). Epiaortic ultrasound scanning (EUS), the current ‘gold’ standard for detecting AA atherosclerosis, has not gained widespread use because there is a lack of optimized devices, it lengthens procedure, endangers sterility, and false belief many surgeons that palpation as sensitive EUS. Furthermore no clear evidence proving epiaortic changes outcome in surgery. Various researchers investigated ability transesophageal echocardiography (TEE) to discriminate between presence absence atherosclerosis. It acknowledged TEE limited value this, but never been supported meta-analysis estimating true diagnostic accuracy based on all quantitative evidence. We aimed do this using state-of-the-art methodology meta-analyses. Methods: searched multiple databases studies comparing vs. EUS detection A random-effects bivariate meta-regression model was used obtain summary estimates sensitivity specificity, incorporating correlation specificity well covariates explore heterogeneity across studies. Results: extracted six with total 346 patients, whom 419 aortic segments were analyzed, including 100 atherosclerosis [median prevalence 25% (range 17–62%)]. Summary 21% (95% CI 13–32%) 99% (96–99%), respectively. Conclusions: Because low negative test result requires verification additional testing scanning. In case positive result, can considered present, less manipulative strategies might indicated.