Role of Transesophageal Echocardiography in the Diagnosis and Management of Traumatic Aortic Disruption

Vignon, Philippe; Guéret, Pascal; Védrinne, J; Lagrange, Philippe; Cornu, Élisabeth; Abrieu, O; Gastinne, Hervé; Bensaïd, J; Lang, Roberto M.

doi:10.1161/01.cir.92.10.2959

Cited by 161 publications

(62 citation statements)

References 29 publications

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“…Smith and coworkers [41] found 11 aortic injuries of 101 traumatized patients, demonstrating a sensitivity of 100% and a specificity of 98% (one false positive). Similar rates were found by Vignon et al [42] in 32 consecutive patients evaluated for blunt chest trauma with only one false negative with a 2-mm medial tear. One hundred percent sensitivity and specificity were found by Buckmaster et al [43] in 160 consecutive patients.…”

Section: Echocardiographysupporting

confidence: 86%

Traumatic injuries: imaging of thoracic injuries

et al. 2002

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Chest trauma is one of the most important causes of death, in particular in individuals under the age of 40 years. The mortality rate for chest trauma, often related to motor vehicle accidents, is approximately 15.5%; it increases dramatically to 77% with associated shock and head injury (Glasgow scores of 3-4). The accurate diagnosis of pathologies consequent to blunt chest trauma depends on a complete knowledge of the different clinical and radiological manifestations. The first diagnostic approach is classically based on chest X-ray often carried out on supine position at the hospital admission. A CT study must then be performed in all chest trauma patients in whom there is even the smallest diagnostic doubt on plain film. In particular, spiral CT (SCT) assumes a fundamental role in the demonstration of mediastinal hemorrhage and direct signs of aortic lesions. At present, SCT is routinely part of a diagnostic evaluation which also includes scans of the brain and the abdomen in polytraumatized patients. Magnetic resonance is the ideal method for visualizing diaphragmatic lesions. Furthermore, recent reports have demonstrated the high diagnostic value of MR in evaluating aortic injuries. The purpose of this article is to review the most common radiological patterns related to chest trauma.

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Section: Echocardiographysupporting

confidence: 86%

Traumatic injuries: imaging of thoracic injuries

et al. 2002

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“…There was one false positive, yielding a sensitivity of 100% and specificity of 98%. Similar sensitivity and specificity were found in 32 trauma patients with suspected traumatic disruption of the aorta (TDA) who underwent TEE [11]. Two aortic injury subtypes were identified; subadventitial TDA (10 patients) and traumatic intimal tear (3 patients).…”

Section: Traumatic Chest Injuriesmentioning

confidence: 59%

Transesophageal echocardiography in the evaluation of the trauma patient: A trauma resuscitation transesophageal echocardiography exam

Leichtle

Singleton

Singh

et al. 2017

Journal of Critical Care

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“…Als Anmerkung soll erlaubt sein, dass in der Studie von Minard et al [12] Untersuchung und Interpretation durch Traumatologen und nicht durch Kardiologen durchgeführt wurden. Saletta et al [17] [3,20]; . Abb.…”

Section: Diagnostik Der Traumatischen Aortenverletzungunclassified

“…Schon 1995 ist durch zwei Arbeitsgruppen auf das Potenzial der TEE hinsichtlich der diagnostischen Trefferquote bei der Detektion von traumatischen Aortenverletzungen hingewiesen worden [18,20].…”

Section: Diskussionunclassified

Stumpfe traumatische Aortenverletzung

et al. 2008

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Traumatic injury of the aorta can be a fatal complication of blunt thoracic trauma and if it is survived and diagnosed, surgery will be necessary. A prerequisite is a prompt imaging diagnosis of the injury in order to plan an optimal therapeutic procedure for the patient, depending on the severity of the injury. Digital angiography has now been replaced by non-invasive methods, such as computer tomography (CT) or transesophageal echocardiography (TEE). Using TEE it is possible to carry out a staging of the injury and this classification together with the corresponding clinical symptoms determines the therapeutic treatment regime. In many cases a staged treatment is standard procedure. In addition to the establishment of an adequate blood pressure (for prophylaxis of the open rupture), monitoring during the course of treatment may be necessary. The main advantage of TEE is that the examination of these mostly multiple traumatised patients can be carried out at the bedside. This review describes the use of TEE as a diagnostic tool in the early phase and for continuous monitoring of an initially conservative treatment regime.

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Role of Transesophageal Echocardiography in the Diagnosis and Management of Traumatic Aortic Disruption

Abstract: TEE should be considered the first-line imaging modality for the evaluation of trauma patients with suspected injuries of the thoracic aorta because of its portability, safety, diagnostic accuracy, and potential impact on patient management.

Cited by 161 publications

References 29 publications

Traumatic injuries: imaging of thoracic injuries

Traumatic injuries: imaging of thoracic injuries

Transesophageal echocardiography in the evaluation of the trauma patient: A trauma resuscitation transesophageal echocardiography exam

Stumpfe traumatische Aortenverletzung

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