• Sarah Yousef, Ibrahim Sultan, Floyd Thoma, Yisi Wang, Garrett Coyan, Michel Pompeu Sá, Derek Serna-Gallegos, Francis Ferdinand, David West, David Kaczorowski, Johannes Bonatti, Danny Chu, and Pyongsoo Yoon.
• J. Thorac. Cardiovasc. Surg. 2024 Oct 25.

ObjectiveTo assess whether use of epiaortic ultrasound for assessment of aortic calcification impacts the rate of postoperative stroke following coronary artery bypass grafting (CABG).MethodsThis was a retrospective study using an institutional database of CABGs performed from 2010 to 2023. All patients undergoing isolated index CABG were included. Patients were dichotomized according to the use of epiaortic ultrasound for intraoperative aortic assessment. Postoperative stroke rates were compared, and multivariable logistic regression for postoperative stroke was performed. Cox regression was performed for the multivariable analysis of mortality.ResultsA total of 10,049 patients underwent isolated index CABG. Intraoperative epiaortic ultrasound was utilized in 1,572 (15.6%) of these patients. The STS predicted risk of stroke was 1% and did not differ between the two groups. Postoperative stroke occurred in 13 patients in the epiaortic ultrasound group (0.8%) versus 116 patients in the group in which epiaortic ultrasound was not used (1.4%, p=0.08). On multivariable logistic regression, use of epiaortic ultrasound was not associated with a reduced odds of postoperative stroke (OR 0.62, 95% CI 0.34-1.14, p=0.12). Epiaortic ultrasound use was also not significantly associated with hazards of mortality on Cox regression (HR 1.14, 95% CI: 0.94, 1.38, p=0.12). Postoperative stroke was significantly associated with an increased hazard of death (HR 2.25, 95% CI: 1.61-3.14, p<0.001).ConclusionStroke rates after CABG were 0.8% and 1.4% with and without the use of epioartic ultrasound, respectively. The current study did not find an independent association between epiaortic ultrasound use and postoperative stroke.Copyright © 2024. Published by Elsevier Inc.

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