Utility of transesophageal echocardiography in the diagnosis of disease of the thoracic aorta. Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. [J Vasc Surg] Journal article | | Title | Utility of transesophageal echocardiography in the diagnosis of disease of the thoracic aorta. | | Author(s) | Wiet SP, Pearce WH, McCarthy WJ, Joob AW, Yao JS, McPherson DD | | Institution | Department of Medicine, Northwestern University Medical School, Chicago, IL. | | Source | J Vasc Surg 1994 Oct; 20(4):613-20. | | MeSH | Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting
Aorta, Thoracic
Aortic Aneurysm, Thoracic
Aortography
Arteriosclerosis
Blood Flow Velocity
Comparative Study
Echocardiography, Transesophageal
Female
Humans
Hyperlipidemia, Familial Combined
Male
Middle Aged
Thrombosis
Tomography, X-Ray Computed
Ultrasonography, Doppler, Color
| | Abstract | PURPOSE: Transesophageal echocardiography (TEE) offers a rapid, minimally invasive method for diagnosing thoracic aortic disease. High-resolution images are possible because of the close proximity of the esophagus and vascular structures within the chest. Lung and chest wall components have little influence on the image quality and a virtually unobstructed view of the heart, thoracic aorta, and pulmonary vasculature is seen. The role of TEE in diagnosing diseases of the thoracic aorta is rapidly developing. The purpose of this study is to define the role of TEE in the diagnosis of thoracic aortic disease.
METHODS: Between July 1, 1989 and December 31, 1992, 1005 TEEs were performed at our center. Of these, 199 (125 men, 74 women) were entered into our aortic disease registry. Indications for the studies included 37 referrals to rule out aortic dissection, 18 to assess aortic aneurysm, 55 to assess for an intraaortic source of embolus, 9 to rule out intraaortic thrombus, and 13 with familial hyperlipidemia being followed to mark response to low-density lipoprotein apheresis. In 67 cases, subclinical aortic plaquing was found incidentally. No complications from the TEE procedure were encountered.
RESULTS: In cases of suspected aortic dissection, TEE was equal to computed tomography (CT) scanning in identifying the type (DeBakey) and extent of thoracic aortic dissection. In addition, TEE provided information regarding functional status of the aortic valve, identified interluminal communications, and assessed blood flow and thrombus burden in the false lumen. TEE correctly identified true aneurysms, intraluminal thrombus, and plaques as possible sources of emboli. One false-positive CT scan result for aortic dissection was seen and was ruled out both by TEE and angiography.
CONCLUSION: Biplane TEE can be considered the method of choice in diagnosing disease of the thoracic aorta. Information from TEE can be obtained at the patient's bedside or in the operating suite, to assess surgical results before procedure termination and afterward for follow-up. Adjunctive magnetic resonance imaging, CT scanning, or aortography may be needed to assess extension of the disease process into the abdomen or pelvis or to plan surgical intervention. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
| | PubMed ID | 7933263 |
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