Transesophageal and Transpharyngeal Ultrasound Demonstration of Reversed Diastolic Flow in Aortic Arch Branches and Neck Vessels in Severe Aortic Regurgitation

Abstract

In the current study, we describe an adult patient with torrential aortic regurgitation due to an aortic dissection flap interfering with aortic cusp motion, in whom a transesophageal echocardiogram with the probe positioned in the upper esophagus and transpharyngeal ultrasound examination demonstrated prominent reversed flow throughout diastole in the left subclavian, left vertebral, left common carotid, and left internal carotid arteries. Another unique finding was the demonstration of aortic valve leaflets held in the fully opened position in diastole by the dissection flap as it prolapsed into the left ventricular outflow tract, dramatically documenting the mechanism of torrential aortic regurgitation in this patient.

Increased cerebrovascular resistance after retrograde cerebral perfusion: A Doppler study

“…The carotid artery was identified on one side or the other and traced peripherally towards the carotid bulb using color flow Doppler imaging. After the bifurcation at the carotid bulb, the vessel with flow parallel to the Doppler beam was the ICA, and the vessel with flow at an oblique angle to the Doppler beam was the ECA (11). Blood flow in the ICA and ECA was recorded Using pulsed-wave Doppler.…”

“…Intra-operative transesophageal echocardiography (TEE) was performed during the surgeries except where contraindicated. Carotid artery flow was detected with a TEE probe at the pharynx (10,11). In some patients, blood flow was followed distal to the carotid Original Article bifurcation between the ICA and ECA.…”