Can epiaortic ultrasound reduce the incidence of intraoperative stroke during cardiac surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether changing operative technique based on epiaortic ultrasound reduces the incidence of intra-operative stroke during cardiac surgery? Altogether 179 papers were found using the reported search, of which eight presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that epiaortic ultrasound is superior to manual palpation in detecting atherosclerosis in the ascending aorta, and the severity of atherosclerosis found is closely correlated to the incidence of postoperative stroke. No touch techniques in patients with severe atherosclerosis may avert this increase in the incidence of stroke.