Naslov
Usefulness of transesophageal echocardiography in the diagnosis of aortic dissection and aneurysm

Autori
Vincelj, Josip

Izvornik
Kardiológia (1210-0048) 12 (2003), 1; 13-20

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
transesophageal echocardiography; aortic dissection; aortic aneurysm; intramural hematoma

Sažetak
Acute aortic dissection is a potential emergency that requires immediate and accurate diagnosis and effective medical, surgical or endovascular treatment. The purpose of this study was to evaluate the usefulness of TEE in the diagnosis of thoracic aortic dissection and aneurysm. Biplane or multiplane TEE were performed in 85 consecutive patients (60 men and 25 women), age range 21-86 years with suspected aortic dissection or aneurysm. To compare and analyze the potential advantages of TEE vs. CT and aortography the following findings was evaluated: visualization of true and false lumen, intimal flap, communication between true and false lumen, pericardial effusion, pleural effusion, intramural hematoma, and thrombus in the false lumen or in the aneurysm. Aortic dissection was detected in 26 patients, intramural hematoma in 4 patients and aortic aneurysm in 22 patients. We also detected aortic regurgitation in 11 patients, poericardial effusion in 9, and pleural effusion in 7 patients. All 26 patients had TEE correct diagnosis of aortic dissection, and 25 patients had a type of dissection. CT, MRI, aortography, surgical and/or necropsy confirmed the TEE diagnosis. Fifteen patients had aortic dissection of Stanford type A, and 11 patients of type B. Comparison with CT, MRI, contrast angiography, and surgical and/or autopsy findings showed that TEE yielded accurate diagnosis in all cases, with sensitivity of 100%, while TTE provided accurate diagnosis in 15 (45%) of patients, with sensitivity of 52% (p<0.001). TEE is a highly sensitive and specific method in the diagnosis of dissection, intramural hematoma and aneurysm of the thoracic aorta. TEE is useful in providing an accurate diagnosis in a short time at the bedside, it is inexpensive, minimally invasive, and does not interfere with other diagnostic and therapeutic procedures.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA