Visualizing the thoracic aorta with modified transoesophageal echocardiography – The A-View technique

EuroEcho_2011

Abstract
The diagnostic value of the A-View technique has been studied in 465 patients undergoing cardiothoracic surgery. Compared to the reference standard (epiaoric ultrasound) atherosclerosis grade >3 in the DAA was diagnosed with a sensitivity of 95% and specificity of 79%. The positive and negative predictive values were 67% and 97% respectively, the area under the curve was 0.89 (0.86 – 0.89). Therefore presence of severe atherosclerosis can safely be ruled out with the A-View technique, although additional testing (e.g EUS) may have to confirm the actual presence of atherosclerosis.
In over 800 patients who have been imaged with the A-View technique one major complication occurred (pulmonary haemorrhage with need for prolonged ventilation, recovered without sequelae). The median SaO2 after the procedure was 98% (SD 3%). The product is FDA and CE certified.

Indications for the use of the A-View technique are:
-Screening for atherosclerosis of distal ascending aorta
-Intraoperative monitoring of cerebral blood flow
-Local TAVI protocol; approach guided by degree of aortic atherosclerosis
-Screening for distal ascending aortic dissection

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