An intraoperative assessment of the ascending aorta: a comparison of digital palpation, transesophageal echocardiography, and epiaortic ultrasonography. J Cardiothorac Vasc Anesth. 2007;21:805 9. 852. Sylivris S, Calafiore P, Matalanis G, et al. The intraoperative assessment of ascending aortic atheroma: epiaortic imaging is superior to both transesophageal echocardiography and direct palpation. J Car- diothorac Vasc Anesth. 1997;11:704 7. 853. Goto T, Baba T, Matsuyama K, et al. Aortic atherosclerosis and postoperative neurological dysfunction in elderly coronary surgical patients. Ann Thorac Surg. 2003;75:1912 8. 854. Hangler HB, Nagele G, Danzmayr M, et al. modification of surgical technique for ascending aortic atherosclerosis: impact on stroke reduction in coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2003;126:391 400. 855. Schachner T, Nagele G, Kacani A, et al. Factors associated with presence of ascending aortic atherosclerosis in CABG patients. Ann Thorac Surg. 2004;78:2028 32. 856. Gold JP, Torres KE, Maldarelli W, et al. Improving outcomes in coronary surgery: the impact of echo-directed aortic cannulation and perioperative hemodynamic management in 500 patients. Ann Thorac Surg. 2004;78:1579 85. 857. Zingone B, Rauber E, Gatti G, et al. The impact of epiaortic ultrasono- graphic scanning on the risk of perioperative stroke. Eur J Cardiothorac Surg. 2006;29:720 8. 858. Durand DJ, Perler BA, Roseborough GS, et al. Mandatory versus selective preoperative carotid screening: a retrospective analysis. Ann Thorac Surg. 2004;78:159 66. 859. Sheiman RG, Janne d Othee B. Screening carotid sonography before elective coronary artery bypass graft surgery: who needs it [published correction appears in Am J Roentgenol. 2007;189:512]. Am J Roentgenol. 2007;188:W475 79. 860. Naylor AR, Mehta Z, Rothwell PM, et al. Carotid artery disease and stroke during coronary artery bypass: a critical review of the literature. Eur J Vasc Endovasc Surg. 2002;23:283 94. 861. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. 