Rupture of Aortic Dissection During Attempted Transesophageal Echocardiography

Kristensen, Steen Dalby; Ivarsen, Hanne R.; Egeblad, Henrik

doi:10.1111/j.1540-8175.1996.tb00912.x

Cited by 13 publications

(3 citation statements)

References 10 publications

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“…19 There are anecdotal reports of deterioration of patients with aortic dissection, during TEE, possibly related to discomfort, gagging or distress. 20 However, no mortality has been reported in larger studies. 16,17,19 Moreover, given the mortality rate of 1-2% per hour, there is a high risk of fatal deterioration while transferring patients for, or during, CT or MRI.…”

Section: Definitive Imaging In Acute Aortic Syndromes: the Role Of Trmentioning

confidence: 98%

Echocardiography in the emergency assessment of acute aortic syndromes

Meredith

Masani

2009

European Journal of Echocardiography

150

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Acute aortic syndrome (AAS) is a collective term for several life-threatening acute aortic conditions: aortic dissection, intramural haematoma (IMH), penetrating atherosclerotic ulcer, and traumatic transection. Mortality from acute ascending aortic (type A) dissection increases rapidly immediately after presentation, reaching 1-2% per hour for the first 48 h. Early surgical intervention is recommended for type A aortic dissection and has been shown to improve outcome. Transthoracic echocardiography is an extremely valuable, often overlooked, clinical tool in diagnosing and assessing AAS in the emergency setting. Although diagnostic sensitivity is suboptimal, it is very useful in assessing potential high risk features or complications, such as pericardial effusion, and diagnosing potential differential conditions. A negative transthoracic echocardiography (TTE), however, does not exclude AAS. In patients with a high risk of type A dissection or IMH (identified clinically or by TTE), the safest and most rapid 'gold standard' investigation is transoesophageal echocardiography, ideally performed with the cardiac surgical team standing by. This is of particular importance in the haemodynamically unstable patient. Transoesophageal echocardiography, helical CT, and MRI have similar diagnostic accuracy and, when there is diagnostic uncertainty or no indication for immediate intervention, should be used according to clinical need, local availability, and expertise.

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Section: Definitive Imaging In Acute Aortic Syndromes: the Role Of Trmentioning

confidence: 98%

Echocardiography in the emergency assessment of acute aortic syndromes

Meredith

Masani

2009

European Journal of Echocardiography

150

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“…193 Considering that 90% of the patients survive if they reach invasive treatment (open surgery and SG deployment), it is desirable to avoid misdiagnosis and resulting delays in transportation by performing a quick and simple echographic examination. However, although the diagnostic ability of TEE is comparable to that of CT, 194 it may induce rupture due to the stimulation of insertion, 195,196 and it is not considered optimal for initial diagnosis.…”

Section: ▋ 36 Echographic Examinationmentioning

confidence: 99%

JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection

Ogino,

Iida,

Akutsu

et al. 2023

Circ J

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▋ 1.3.2 Location of AneurysmsAneurysms are classified into thoracic, thoracoabdominal, and abdominal aneurysms, which are further classified as follows: Thoracic: It is further classified into ascending, arch, and descending aortic aneurysms. Thoracoabdominal: The Crawford classification based on the range of replacement in thoracoabdominal aneurysm surgery (Figure 5). Abdominal: Abdominal aortic aneurysms are classified using the renal artery as the reference into the supra-and infra-renal segments. ▋ 1.3.3 CauseBased on the cause of the aneurysm, aortic aneurysms are classified into atherosclerotic, traumatic, inflammatory, infected, congenital, etc. Most of them are atherosclerotic aortic aneurysms. Advance Publication13 JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection is indicated for saccular aneurysms regardless of the size of the thickening (See PQ 1). Inflammatory aortic aneurysm: Aneurysm caused by inflammation. Although, in general, "inflammation" is a concept that includes infection, however, inflammatory aortic aneurysm does not include the aortic aneurysm with infection. Inflammatory periaortitis: A case with inflammation around the aorta but with less aortic dilation that does not meet the criteria of aneurysm. Infected aortic aneurysm: Aneurysm caused by infection. Rupture: Extravascular blood leakage due to damage to the arterial wall. Impending rupture: The absence of damage to the arterial wall despite the presence of aneurysmal pain. ▋ 4.2 Aortic DissectionDissecting aneurysm: Aortic dissection with aneurysmal formation. A general term that was previously used for overall aortic dissection. However, because in many cases with aortic dissection in acute phase does not meet the criteria for an aneurysm, aortic dissection in acute phase is now called, "acute aortic dissection." True lumen: The original arterial cavity. False lumen: A new cavity formed in the arterial wall (the term "dissection cavity" is not appropriate). Dissection flap: The (intima-media) septal wall. It used to be called "intimal dissection." However, it actually consists of intima and a part of the media. Tear: Intimal and medial tears of aortic dissection which is the site of communication between the true lumen and the false lumen. "Intimal tear" is also regularly used as a synonym for "tear". Entry: A site where blood flow enters from the true lumen to the false lumen. Re-entry: A site where blood flow enters from the false lumen to the true lumen. ("communication window" that is also used as a term for both entry and re-entry) Aortic dissection with patent false lumen: It is a synonym for "communicating aortic dissection", a type of aortic dissection in Europe classification. It is also called "classic dissection" or "double barrel aorta." One of the three types of aortic dissection in Japanese Aortic dissection with thrombosed false lumen: It is a synonym for "noncommunicating aortic dissection", a type of aortic dissection in Europe classification. One of the three ty...

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“…2 However, insertion and manipulation of a TEE probe may lead to a variety of complications. [3][4][5][6][7][8][9][10] Trauma associated with insertion and maneuvering of a TEE probe may predispose a patient to develop airway swelling while in the sitting position.…”

Section: Introductionmentioning

confidence: 99%