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A 17-French aortic cannula was successfully placed using TEE guidance with the tip proximal to the mobile atheroma to avoid inadvertent disruption and subsequent embolic sequelae. The patient had no evidence of perioperative stroke or other complications postoperatively. This case demonstrates one strategy to manage severe atheromatous disease intraoperatively. We also review additional management options.<\/jats:p>","DOI":"10.1155\/2020\/8820948","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T01:35:06Z","timestamp":1604626506000},"page":"1-4","source":"Crossref","is-referenced-by-count":0,"title":["Aortic Cannulation around Grade 5 Aortic Arch Atheroma Utilizing Transesophageal Echocardiography"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7830-8916","authenticated-orcid":true,"given":"Trey W.","family":"Vanek","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5091-7069","authenticated-orcid":true,"given":"Jeremiah","family":"Hayanga","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Ellison","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Puette","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8230-0397","authenticated-orcid":true,"given":"Lawrence","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2806-5167","authenticated-orcid":true,"given":"Heather K.","family":"Hayanga","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"doi-asserted-by":"publisher","key":"1","DOI":"10.4103\/ija.ija_379_17"},{"doi-asserted-by":"publisher","key":"2","DOI":"10.1016\/s1010-7940(01)00649-2"},{"key":"3","article-title":"Adult cardiac surgery data collection. 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