Modified transesophageal echocardiography of the dissected thoracic aorta; a novel diagnostic approach

Jansen Klomp_2016 Cardio Vasc Ultrasound-page-001Abstract

Transesophageal echocardiography (TEE) is a key diagnostic modality in patients with acute aortic dissections, yet its sensitivity is limited by the ‘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 it was demonstrated that 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 also guide the surgical management and monitor perfusion of cerebral arteries.

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