TEE in the mid-esophageal long axis imaging plane and epiaortic scan

A TEE still in the mid-esophageal long axis imaging plane (A) demonstrates heavy calcification of the root, sinotubular junction, and tubular ascending aorta. There is a particularly heavy calcium burden on the posterior wall (nearest to the TEE probe). An epiaortic scan (B) of the same patient demonstrates a significant circumferential atheroma which would preclude cannulation or cross-clamping at this site.