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  • Print publication year: 2010
  • Online publication date: May 2010

12 - The thoracic aorta

from Section 1 - Fundamentals of transesophageal echocardiography

Summary

Intraoperative transesophageal echocardiography (TEE) is increasingly being used to assess ventricular function in patients about to undergo coronary revascularization, and it should always be used to assess the result of surgery and cardiac function both following bypass and/or at the time of chest closure. The development of standard chocardiographic views, coupled with agreed terminology for describing manipulation of the TEE probe, has been essential for the development of TEE into an effective imaging modality. Th e 20 standard views described in 1999 form the basis of the TEE study. Echocardiographic examination of left ventricular function can reveal useful information when the heart is at rest or under stress with a pharmacological agent such as dobutamine. In order to evaluate each part accurately, the left ventricle has been divided into a number of segments. TEE is particularly useful for examining the mitral valve.

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References

1. GarcierJM, PetitcolinV, FilaireM, et al. Normal diameter of the thoracic aorta in adults: a magnetic resonance imaging study. Surg Radiol Anat 2003; 25: 322–9.
2. RosenbergerP, ShernanSK, LöfflerM, et al. The influence of epiaortic ultrasonography on intraoperative surgical management in 6051 cardiac surgical patientsAnn Thorac Surg 2008; 85: 548–53.
3. DjaianiG, AliM, BorgerMA, et al. Epiaortic scanning modifies planned intraoperative surgical management but not cerebral embolic load during coronary artery bypass surgery. Anesth Analg 2008; 106: 1611–18.
4. LiYL, WongDT, WeiW, LiuJ. A novel acoustic window for trans-oesophageal echocardiography by using a saline-filled endotracheal balloon. Br J Anaesth 2006; 97: 624–9.
5. PantinEJ, CheungAT. Transesophageal echocardiographic evaluation of the aorta and pulmonary artery. In: KonstadtSN, ShernanS, OkaY, eds., Clinical Transesophageal Echocardiography: a Problem-Oriented Approach, 2nd edn. Philadelphia, PA: Lippincott Williams & Wilkins, 2003: 215–44.
6. WarnesCA. Bicuspid aortic valve and coarctation: two villains part of a diffuse problem. Heart 2003; 89: 965–6.
7. FedakPW, VermaS, DavidTE, et al. Clinical and pathophysiological implications of a bicuspid aortic valve. Circulation 2002; 106: 900–4.
8. AndradeA, Vargas-BarronJ, RijlaarsdamM, et al. Utility of transesophageal echocardiography in the examination of adult patients with patent ductus arteriosus. Am Heart J 1995; 130: 543–6.
9. ShyuKG, LaiLP, LinSC, ChangH, ChenJJ. Diagnostic accuracy of transesophageal echocardiography for detecting patent ductus arteriosus in adolescents and adults. Chest 1995; 108: 1201–5.
10. GoldbergSP, SandersC, NandaNC, HolmanWL. Aortic dissection with intimal intussusception: diagnosis and management. J Cardiovasc Surg (Torino) 2000; 41: 613–15.
11. RuvoloG, VociP, GrecoE, et al. Aortic intussusception: a rare presentation of type A aortic dissection evidenced by transesophageal echocardiography. J Cardiovasc Surg (Torino) 1993; 34: 385–7.
12. KorkutAK, CetinG, SaltikL. Management of a large pseudo-aneurysm secondary to balloon angioplasty for aortic coarctation. Acta Chir Belg 2006; 106: 107–8.
13. AydoganU, DindarA, GurganL, CantezT. Late development of dissecting aneurysm following balloon angioplasty of native aortic coarctation. Cathet Cardiovasc Diagn 1995; 36: 226–9.
14. MiyatakeT, MatsuiY, SutoY, et al. A case of intraoperative acute aortic dissection caused by cannulation into an axillary artery. J Cardiovasc Surg (Torino) 2001; 42: 809–11.
15. AlfonsoF, AlmeríaC, Fernández-OrtízA, et al. Aortic dissection occurring during coronary angioplasty: angiographic and transesophageal echocardiographic findings. Cathet Cardiovasc Diagn 1997; 42: 412–15.
16. MolesVP, ChappuisF, SimonetF, et al. Aortic dissection as complication of percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn 1992; 26: 8–11.
17. BansalRC, ChandrasekaranK, AyalaK, SmithDC. Frequency and explanation of false negative diagnosis of aortic dissection by aortography and transesophageal echocardiography. J Am Coll Cardiol 1995; 25: 1393–401.
18. NienaberCA, von KodolitschY, NicolasV, et al. The diagnosis of thoracic aortic dissection by noninvasive imaging procedures. N Engl J Med 1993; 328: 1–9.
19. SmithAD, SchoenhagenP. CT imaging for acute aortic syndrome. Cleve Clin J Med 2008; 75: 7–9, 12, 15–17, 23–4.
20. ChughtaiA, KazerooniEA. CT and MRI of acute thoracic cardiovascular emergencies. Crit Care Clin 2007; 23: 835–53.
21. AdachiH, OmotoR, KyoS, et al. Emergency surgical intervention of acute aortic dissection with the rapid diagnosis by transesophageal echocardiography. Circulation 1991; 84 (5 Suppl): III14–19.
22. SongJK. Diagnosis of intramural haematomaHeart 2004; 90: 368–71.
23. Mohr-KahalyS, ErbelR, KearneyP, PuthM, MeyerJ. Aortic intramural hemorrhage visualized by transesophageal echocardiography: findings and prognostic implications. J Am Coll Cardiol 1994; 23: 658–64.
24. SvenssonLG, LabibSB, EisenhauerAC, ButterlyJR. Intimal tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. Circulation 1999; 99: 1331–6.
25. CheitlinMD, ArmstrongWF, AurigemmaGP, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). Circulation 2003; 108: 1146–62.
26. KouchoukosNT, DougenisD. Surgery of the thoracic aorta. N Engl J Med 1997; 336: 1876–88.
27. GardnerTJ, HornefferPJ, ManolioTA, et al. Stroke following coronary artery bypass grafting: a ten-year study. Ann Thorac Surg 1985; 40: 574–81.
28. ColettiG, TorraccaL, La CannaG, et al. Diagnosis and management of cerebral perfusion phenomenon during aortic dissection repair by transesophageal Doppler echocardiographic monitoring. J Card Surg 1996; 11: 355–8.
29. KatzES, TunickPA, RusinekH, et al. Protruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypass: experience with intraoperative transesophageal echocardiography. J Am Coll Cardiol 1992: 20: 70–7.
30. JonesEF, KalmanJM, CalafioreP, TonkinAM, DonnanGA. Proximal aortic atheroma: an independent risk factor for cerebral ischemia. Stroke 1995; 26: 218–24.
31. AmarencoP, CohenA, TzourioC, et al. Atherosclerotic disease of the aortic arch and risk of ischemic stroke. N Engl J Med 1994; 331: 1474–9.
32. TunickPA, RosenzweigBP, KatzES, et al. High risk for vascular events in patients with protruding aortic atheromas: a prospective study. J Am Coll Cardiol 1994; 23: 1085–90.
33. The French Study of Aortic Plaques in Stroke Group. Atherosclerotic disease of the aortic arch as a risk factor for recurrent ischemic stroke. N Engl J Med 1996; 334: 1216–21.
34. RoyseC, RoyseA, BlakeD, GriggL. Assessment of thoracic aortic atheroma by echocardiography: a new classification and estimation of risk of dislodging atheroma during three surgical techniques. Ann Thorac Cardiovasc Surg 1998; 4: 72–7.
35. KonstadtSN, ReichDL, KahnR, ViggianiRF. Transesophageal echocardiography can be used to screen for ascending aortic atherosclerosis. Anesth Analg 1995; 81: 225–8.
36. MizunoT, ToyamaM, TabuchiN, et al. Thickened intima of the aortic arch is a risk factor for stroke with coronary artery bypass grafting. Ann Thorac Surg 2000; 70: 1565–70.
37. KutzSM, LeeVS, TunickPA, KrinskyGA, KronzonI. Atheromas of the thoracic aorta: a comparison of transesophageal echocardiography and breath-hold gadolinium-enhanced 3-dimensional magnetic resonance angiography. J Am Soc Echocardiogr 1999; 12: 853–8.
38. MachlederHI, TakiffH, LoisJF, HolburtE. Aortic mural thrombus: an occult source of arterial thrombo-embolism. J Vasc Surg 1986; 4: 473–8.
39. HartmanGS, YaoFS, BruefachM, et al. Severity of aortic atheromatous disease diagnosed by transesophageal echocardiography predicts stroke and other outcomes associated with coronary artery surgery: a prospective study. Anesth Analg 1996; 83: 701–8.
40. SylivrisS, CalafioreP, MatalanisG, et al. The intraoperative assessment of ascending aortic atheroma; epiaortic imaging is superior to both transesophageal echocardiography and direct palpation. J Cardiothorac Vasc Anesth 1997; 11: 704–7.
41. BansalRC, AshmeikK, RazzoukAJ. An unusual case of vegetative aortitis diagnosed by transesophageal echocardiography. J Am Soc Echocardiogr 2001; 14: 237–9.
42. PretreR, ChilcottM. Blunt trauma to the heart and great vessels. N Engl J Med 1997; 336: 626–32.