Coarctation of the Aorta: Quantitative Analysis by Transesophageal Echocardiography

Abstract

Summary Transesophageal echocardiography and standard two‐dimensional echocardiography were performed in 15 patients with suspected coarctation of the aorta. Aortic diameters and crosssectional areas were determined by means of TEE and compared with clinical findings and catheterization data. The isthmus of the aorta could be imaged in all patients using TEE, but in only seven patients using standard suprasternal echocardiography. Compared with controls, aortic diameters were narrowed in 9 of 15 patients, and cross‐sectional areas were reduced in 13 of 15. There was a satisfactory correlation between TEE data and angiographic and hemodynamic data. TEE is a promising method of a diagnosing and quantifying coarctation of the aorta, and is more sensitive than conventional two‐dimensional and Doppler echocardiography.

Detection of dissection of the aortic intima and media after angioplasty of coarctation of the aorta. An angiographic, computer tomographic, and echocardiographic comparative study.

“…'8 Transesophageal echocardiography has been proven a reliable method for scanning the aorta and the coarctation site by means of cross-sectional images. 19 Additionally, it is possible for a dissection of the aorta to be visualized with high accuracy by transesophageal echocardiography.20,21 High-resolution tomographic images of the descending aorta in multiple planes can be obtained. Transesophageal echocardiography was, therefore, used to monitor PTA of coarctation of the aorta to provide information about morphological and functional changes of the aorta in adult patients.…”

“…At a depth of 20-30 cm, the echoscope was withdrawn in 3-5-mm steps, at each of which the aorta was scanned to detect the coarctation site, which was recognized by the slightly increased distance between the aorta and the esophagus. 19 The aorta was analyzed where its cross-sectional area was smallest. Because images taken during positioning of the catheter were disturbed by the multiple artifacts produced by the catheter and the balloon, the aorta was continuously imaged 1-2-cm distal to the coarctation site.…”

Transesophageal Ultrasound Guidance for Endovascular Interventions on the Aorta

“… 31 32 Unlike in other congenital heart defects, 11 the role of TEE in the assessment of aortic coarctation is not yet well defined, although it has been used successfully for diagnosis, quantification, and interventional guidance in children. 33 34 35 The reluctance to use TEE may be explained by interference with the angiographic assessment of coarctation and its limitations to image the supra-aortic branches. Conversely, TEE is essential to check for additional intracardiac defects that should always be ruled out, as their association with coarctation is not uncommon.…”