Pulmonary aspiration of the gastric contents is a serious perioperative complication.  The overall incidence in a mixed surgical population ranges between <0.1% and 19% depending on patient and surgical factors and it has not changed in the last few decades. Aspiration pneumonia is associated with significant morbidity, including prolonged mechanical ventilation, and carries a risk of mortality as great as 5%. Pulmonary aspiration is involved in up to 9% of all anaesthesia-related deaths. One of the main risk factors for aspiration is the presence of gastric content. The critical volume threshold of gastric fluid that by itself increases aspiration risk is controversial, but healthy, fasted patients frequently have residual gastric volumes (GVs) of up to 1.5 ml kg−1 without significant aspiration risk. Sedation and general anaesthesia depress or impede the physiological mechanisms that protect against aspiration (the tone of the lower oesophageal sphincter and upper airway reflexes). Since restriction of fluid and food intake before general anaesthesia is vital for patient safety, anaesthesiology societies have developed guidelines for preoperative fasting.. In preoperative fasting guidelines, at least 2 hours for clear liquids is recommended, 6 hours of fasting for liquids containing solid particles and toasted sandwich type solid foods, and 8 hours of fasting for high calorie and fatty foods. Patients with BMI over 30 and type 2 diabetes may benefit from point of care ultrasonography to guide perioperative airway management by stratifying gastric residual volume. The evaluation of gastric content by ultrasound is a good method to qualitatively and quantitatively assess the gastric volume and thus determine the risk of perioperative pulmonary aspiration.As cardiac surgeries are long duration surgeries so case posted in afternoon shift  have a prolong fasting period . As per present CVTS protocol all the patients are kept fasted from midnight so to avoid this prolong fasting we can do sonography of stomach preoperatively to decide whether it is needed to keep patient fasting from midnight or we can keep them fasted from morning when posted for afternoon schedule.