RT Journal
A1 Hart SA, Krasuski RA, Blackstone E
T1 INtraoperative diagnosis and management of patent foramen ovale—reply
JF JAMA
JO JAMA
YR 2009
FD December 2
VO 302
IS 21
SP 2317
OP 2318
DO 10.1001/jama.2009.1745
UL http://dx.doi.org/10.1001/jama.2009.1745
AB 
In Reply: Dr Mirakaj and colleagues highlight the effect of atheromatous disease of the aorta on perioperative stroke. We agree that epiaortic echocardiography is a more sensitive manner to detect atheroma, but the results of these studies have not been systematically collected at our institution. However, qualitative aortic arch atheroma data from transesophageal echocardiography were available in nearly all of our patients and were included in our analysis. The high prevalence of atheroma seen in this population makes it unlikely that many such plaques were missed using this technique.