Impact of Intraoperative Transesophageal Echocardiography on Acute Type-A Aortic Dissection

The Potential of Computational Fluid Dynamics Simulation on Serial Monitoring of Hemodynamic Change in Type B Aortic Dissection

“…Information of flow direction and location of entry sites can be obtained for answering specific questions such as endoleak in localized regions. However, TEE is operator dependent and limited to the thoracic aorta, it does not provide an overall picture of flow information throughout the aorta [22,23]. CFD is the only non-invasive investigation that may provide information on pressure.…”

Intraoperative Transesophageal Echocardiography: Review and Evolution

“…Thorsgard et al, in a retrospective study showed that TEE data led to a change in planned surgery in 39% of the patients in acute type-A AD. According to the previous literature, this number is a little higher (6-30%) but it is specific for this surgery and it can be as high as in other emergent surgery procedures, entirely distinctive of the complete data that is required in an elective surgery patient [41].…”

Diagnostic challenges with transesophageal echocardiography for intraoperative iatrogenic aortic dissection

“…[ 6 ] Intraoperative TEE used on acute type-A aortic dissection changes surgical plan in 39% of patients, giving credence to its utility in giving high-quality care. [ 10 ] Drawbacks to TEE include operator-dependent skill and variable visualization of the proximal arch and distal part of ascending aorta secondary to interposition of the trachea between ascending aorta and esophagus. [ 11 12 ] In the incidence, TEE examination is ineffective in detecting a dissection, other modalities are available and include magnetic resonance imaging, computerized tomography, aortography, and epiaortic ultrasound exam (EAU).…”

“…[ 11 12 ] In the incidence, TEE examination is ineffective in detecting a dissection, other modalities are available and include magnetic resonance imaging, computerized tomography, aortography, and epiaortic ultrasound exam (EAU). [ 10 12 ] Given the intraoperative nature of iatrogenic dissection, decision-making and time for intervention make TEE, EAU, and aortography the most reasonable options. [ 12 ] In this case, an EAU comprehensive exam was done.…”