Key points
- Perioperative stroke during cardiac surgery is ofter cuased by emboli arising from atherosclerosis in the AA, as this is where cannulation and clamping occurs.
- EUS of the AA may be used to detect atherosclerosis before cannulation but can only be applied during surgery
- A-View device allows TOE to be used to make an assessment of aortic atheroma before sternotomy
- TOE using the A-View device had a high negative predictive value in excluding relevant aortic atheroma before sternotomy
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