Intraoperative Imaging for Porcelain Aorta
Intraoperative Imaging for Porcelain Aorta
Diffuse calcification of ascending aorta which may extend down is known as “Porcelain aorta”. Intraoperative epiaortic echocardiography along with manual palpation during surgery has been described as the most sensitive technique for detecting ascending aortic atheroma and calcification [1].
A prospective study evaluated this in hundred consecutive patients undergoing coronary bypass or valve surgery [2]. Ascending aorta was assessed by manual palpation by the operating surgeon, intraoperative transesophageal echocardiography and epiaortic ultrasound using linear and phased-array imaging. No difference was noted between linear and phased array probes. But epiaortic probes were superior to manual palpation in all segments of the aorta. It was also superior to transesophageal echocardiography in mid and distal segments of ascending aorta.
The study concluded that intraoperative epiaortic ultrasound with either a linear or phased array transducer was the best method for detection of ascending aortic atheroma. It was mentioned that transesophageal echocardiography was an insensitive technique for evaluation of mid and distal ascending aortic atheroma. Hence it would be of little value in guiding surgical manipulations such as cross-clamping. It may be noted that preoperative computed tomography is quite useful in evaluating in ascending aortic calcification [3].
References
Abramowitz Y, Jilaihawi H, Chakravarty T, Mack MJ, Mak...
Source: Cardiophile MD - Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
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