The value of intra-operative epiaortic scanning in patients submitted for coronary artery bypass grafting / Mostafa Mahmoud Atta ; Supervised Mohammed Magdy Gomaa , Hesham Zayed Saleh , Alaa Mohammed Omar

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Background & Objectives: Stroke is the dreaded complication of cardiac surgery. Atherosclerosis of the ascending aorta and the aortic arch is one of the most significant risk factors for peri-operative stroke.The purpose of this study was to assess the value of EAS in prevention of stroke and compare performance to TEE. Methodology : We studied 100 patients who underwent primary isolated CABG from may 2016 into may 2017 as it represent 40% of total primary isolated CABG was done in this time. Patients were prospectively randomized into Two groups.These study was performed in KOBRY EL KOBA Military Hospital. Patients were divided into Epiaortic group "Group A" and TEE & palpation group "Group B ". The primary endpoint of this study was an incidence of early post-operative stroke. The secondary endpoint of this study was an incidence of early post-operative MI , AF , renal failure , deep wound infection. Results: 100 patients who underwent isolated CABG , The patients were classified into two groups: In Group 2A3 , age ranged from 46-73 years with a mean of 60 ± 10.1, while in Group 2B3 , age ranged from 48-71 years with a mean of 57.6 ± 13.5, and there was no statistical significance (P valve >0.05).In Group 2A3, there was 36 males (72%) and 14 females (28%), while in Group 2B3 there was 40 males (80%) and 10 females (20%) with no statistical significance (P value >0.05).Group 2A3 38 underwent on-pump while 12 underwent off-pump under EAS, Group 2B3 44 underwent on-pump while 6 underwent off-pump under TEE and palpation. Pre-operative assessment in group 2A3 showed that the ejection fraction (EF) in group 2A3 was 63.7 ± 4.1 %, while in group 2B3 it was 61.3 ± 4.3 % with a P value >0.05

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