Assessment of transesophageal doppler echography in dissecting aortic aneurysm

To assess the clinical value of transesophageal Doppler echography in the diagnosis of dissecting aortic aneurysm, both transesophageal and conventional echograms were performed in 22 cases of dissecting aortic aneurysm. Of the 22 patients, 17 underwent angiography; 8, X-ray computed tomography; 4,...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1989-11, Vol.14 (5), p.1253-1262
Main Authors: Hashimoto, Satoshi, Kumada, Toshiaki, Osakada, Genta, Kubo, Shigeru, Tokunaga, Shingo, Tamaki, Shunichi, Yamazato, Arid, Nishimura, Kazunobu, Ban, Toshihiko, Kawai, Chuichi
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting - diagnosis
Aorta, Abdominal - pathology
Aorta, Thoracic - pathology
Aortic Aneurysm - diagnosis
Aortic Valve Insufficiency - diagnosis
Aortography
Cardiac Tamponade - diagnosis
Echocardiography, Doppler - methods
Esophagus
Female
Hemorrhage - diagnosis
Humans
Male
Middle Aged
Tomography, X-Ray Computed
Transducers
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Summary:To assess the clinical value of transesophageal Doppler echography in the diagnosis of dissecting aortic aneurysm, both transesophageal and conventional echograms were performed in 22 cases of dissecting aortic aneurysm. Of the 22 patients, 17 underwent angiography; 8, X-ray computed tomography; 4, both; and 12, surgery. The performance of each method was assessed in the following four segments: A, ascending aorta; B, aortic arch; C, thoracic descending aorta; and D, upper abdominal aorta. The results by angiography were presumed to be correct. In the group of 17 patients who underwent angiography, the rate of correct detection of an intimal flap using the transesophageal approach was 100% in all four segments, significantly better than detection by the conventional approach (segment A, 65%; segment B, 47%; segment C, 35%; segment D, 53%) (p < 0.01), and the rate of correct detection of the entry sites using the transesophageal approach was 100%, significantly better than that by conventional approach (42%) (p < 0.05). X-ray computed tomography was not capable of detecting the site of entry in all cases. The presence of thrombus, aortic regurgitation and pericardial hemorrhage were all revealed clearly by the transesophageal approach, and the results were partly proved by other methods. In conclusion, transesophageal Doppler echography provides a rapid and accurate method of diagnosing and evaluating dissecting aortic aneurysm and permits prompt initiation of appropriate treatment.
ISSN:0735-1097
1558-3597
DOI:10.1016/0735-1097(89)90424-5