Identification of dissection or aneurysm of the descending thoracic aorta by conventional and transesophageal two-dimensional echocardiography

Engberding, Rolf; Bender, F; Grosse-Heitmeyer, W; Most, Eckhard; Müller, Ulf Steffen; Bramann, H U; Schneider, Diethold

doi:10.1016/0002-9149(87)91205-7

Cited by 36 publications

(6 citation statements)

References 6 publications

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“…Transesophageal echocardiography has provided a method to overcome obstacles to the transmission of ultrasound through the thorax and has proven to be of great value in visualizing posteriorly located cardiac structures. [13][14][15][16] In making the transition from transthoracic to transesophageal echocardiography, it has often been assumed that the presentation of a particular regurgitant flow disturbance will be similar by both methods. It is also assumed that the general (overall) visual estimation of valvular regurgitation will use the same methodology for both methods.…”

Section: Discussionmentioning

confidence: 99%

“…For the subgroup with mitral insufficiency, valve lesions visualized by both techniques were larger by the transesophageal approach (n= 18, 6.0 versus 3.6 cm2, p =0.008). Semiquantitative visual grading of individual valve lesions by two independent observers revealed a higher grade of regurgitation with more jets classified as mild (38 versus 25), moderate (18 versus 13), and severe (17 versus 10) by esophageal imaging than by transthoracic imaging. Thus, transesophageal color flow mapping techniques yield a higher prevalence of valvular regurgitation than do transthoracic techniques in the same patients.…”

mentioning

confidence: 90%

“…However, this factor may be offset by shallower depths and fewer tissue interfaces from the transesophageal window. Studies were performed at a mean depth scale of 11.6 cm (range, 6-15 cm) by the transesophageal approach compared with a mean of 16.8 cm (range, [12][13][14][15][16][17][18][19][20][21][22] cm) for the transthoracic method (p<0.0001). The mitral valves were located at a mean depth of 5.6 cm with regurgitant jets emanating toward the transducer by esophageal studies.…”

Section: Technical Considerationsmentioning

confidence: 99%

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Regurgitant jet size by transesophageal compared with transthoracic Doppler color flow imaging.

et al. 1991

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Combined echocardiography and Doppler color flow mapping from transthoracic imaging windows has become the standard method for the noninvasive assessment of valvular regurgitation. This study compared regurgitant jet areas by Doppler color flow imaging derived from the newer transesophageal approach with measurements obtained from conventional transthoracic apical views. Maximal regurgitant jet area determinations and an overall visual estimate of lesion severity were obtained from 42 patients who underwent color flow examination by both techniques. Seventy-three regurgitant lesions were visualized by transesophageal flow imaging: 34 mitral, 22 aortic, and 17 tricuspid jets. Transthoracic studies in the same patients revealed fewer regurgitant lesions for each valve; 20 mitral, 16 aortic, and 12 tricuspid (p = 0.0009). A comparison of maximal jet areas determined by transesophageal and transthoracic studies showed a good overall correlation (r = 0.85, SEE = 2.8 cm2) and a systematic overestimation by the transesophageal technique (TEE = 0.96 TTX + 2.7). For the subgroup with mitral insufficiency, valve lesions visualized by both techniques were larger by the transesophageal approach (n = 18, 6.0 versus 3.6 cm2, p = 0.008). Semiquantitative visual grading of individual valve lesions by two independent observers revealed a higher grade of regurgitation with more jets classified as mild (38 versus 25), moderate (18 versus 13), and severe (17 versus 10) by esophageal imaging than by transthoracic imaging. Thus, transesophageal color flow mapping techniques yield a higher prevalence of valvular regurgitation than do transthoracic techniques in the same patients. Jet area and the overall estimate of regurgitant lesion severity were also greater by transesophageal color Doppler imaging compared with standard transthoracic imaging.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 90%

Section: Technical Considerationsmentioning

confidence: 99%

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Regurgitant jet size by transesophageal compared with transthoracic Doppler color flow imaging.

et al. 1991

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“…Contrary to the transthoracic echocardiography, T E E has no relation to thorax configuration, obesity, or respiration. The descending thoracic aorta can be imaged in as many section planes as desired [10][11][12][13]. T E E limitations include difficulties in imaging the distal ascending aorta and to some extent, the aortic arch, because of the position of the air-filled trachea [2,11,12].…”

Section: Echocardiographic Evaluationmentioning

confidence: 99%

Diagnosis of aortic dissection: The value and limitations of transesophageal echocardiography

Paczek¹,

Rydlewska-Sadowska²

1995

Int J Angiol

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“…Aortic aneurysm, dissection and coarctation are readily detected [13][14][15]. Our experience covers 50 patients suspected of having thoracic aorta pathology; of these, 22 patients underwent surgery of the thoracic aorta.…”

Section: Pathology Of the Thoracic Aortamentioning

confidence: 99%

Oesophageal echocardiography

Gussenhoven

Taams²,

Roelandt³

et al. 1987

Int J Cardiac Imag

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The diagnostic value of oesophageal echocardiography is most striking in patients in whom precordial studies are of inadequate quality or fail to establish a definitive diagnosis. Oesophageal studies have excellent image quality, can be completed within 10 minutes without complications and, in most instances, enables the clinical question to be answered. In 50 patients referred for suspected thoracic aorta pathology, oesophageal echocardiography correctly excluded or diagnosed the type of aortic dissection, aortic aneurysm or the site of coarctation. Of 35 patients referred with suspected infective endocarditis, oesophageal echocardiography revealed complications in 18 patients, including vegetation, mycotic aneurysm, abscess or chordal rupture. Oesophageal echocardiography is extremely helpful to visualize intracardiac mass lesions. In 27 patients with a history of systemic or pulmonary embolism, the technique confirmed the presence, size and position of a mass lesion in 11 patients. Oesophageal color Doppler flow imaging further expands the diagnostic capabilities, particularly in patients with mitral valve prosthesis. Our experience indicates that oesophageal echocardiography significantly extends the diagnostic potential of echocardiography. Detailed knowledge of cardiothoracic anatomy and its pathologic sequelae is, however, a prerequisite for the efficient and safe application of this method.

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Identification of dissection or aneurysm of the descending thoracic aorta by conventional and transesophageal two-dimensional echocardiography

Cited by 36 publications

References 6 publications

Regurgitant jet size by transesophageal compared with transthoracic Doppler color flow imaging.

Regurgitant jet size by transesophageal compared with transthoracic Doppler color flow imaging.

Diagnosis of aortic dissection: The value and limitations of transesophageal echocardiography

Oesophageal echocardiography

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