Modified transesophageal echocardiography of the dissected thoracic aorta; A novel diagnostic approach
| Autor: | George J. Brandon Bravo Bruinsma, Linda M. Peelen, Arno P. Nierich, Wouter W. Jansen Klomp, Jan G. Grandjean, Arnoud W J van 't Hof |
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| Přispěvatelé: | Faculty of Engineering Technology |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Aortic arch
medicine.medical_specialty Cerebral monitoring Aortic dissection Lumen (anatomy) Aorta Thoracic Review 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine.artery Internal medicine IR-105007 medicine Journal Article Thoracic aorta Humans Radiology Nuclear Medicine and imaging Cerebral perfusion pressure METIS-318358 Transesophageal echocardiography Angiology Aortic atherosclerosis Aortic Aneurysm Thoracic business.industry General Medicine Cardiothoracic surgery medicine.disease How I do it article Radiology Nuclear Medicine and imaging Cardiology cardiovascular system Radiology Erratum business Cardiology and Cardiovascular Medicine human activities Echocardiography Transesophageal |
| Zdroj: | Cardiovascular Ultrasound, 14. BioMed Central Cardiovascular ultrasound, 14(1):28. BioMed Central Ltd. Cardiovascular Ultrasound |
| ISSN: | 1476-7120 |
| Popis: | Background Transesophageal echocardiography (TEE) is a key diagnostic modality in patients with acute aortic dissection, yet its sensitivity is limited by a “blind-spot” caused by air in the trachea. After placement of a fluid-filled balloon in the trachea visualization of the thoracic aorta becomes possible. This method, modified TEE, has been shown to be an accurate test for the diagnosis of upper aortic atherosclerosis. In this study we discuss how we use modified TEE for the diagnosis and management of patients with (suspected) acute aortic dissection. Novel diagnostic approach of the dissected aorta Modified TEE provides the possibility to obtain a complete echocardiographic overview of the thoracic aorta and its branching vessels with anatomical and functional information. It is a bedside test, and can thus be applied in hemodynamic instable patients who cannot undergo computed tomography. Visualization of the aortic arch allows differentiation between Stanford type A and B dissections and visualization of the proximal cerebral vessels enables a timely identification of impaired cerebral perfusion. During surgery modified TEE can be applied to identify the true lumen for cannulation, and to assure that the true lumen is perfused. Also, the innominate- and carotid arteries can be assessed for structural integrity and adequate perfusion during multiple phases of the surgical repair. Conclusions Modified TEE can reveal the “blind-spot” of conventional TEE. In patients with (suspected) aortic dissection it is thus possible to obtain a complete echocardiographic overview of the thoracic aorta and its branches. This is of specific merit in hemodynamically unstable patients who cannot undergo CT. Modified TEE can guide also guide the surgical management and monitor perfusion of the cerebral arteries. Electronic supplementary material The online version of this article (doi:10.1186/s12947-016-0071-6) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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