Transesophageal Echocardiographic Identification of Thrombus Producing Obstruction of Left Pulmonary Artery Descending Lobar Branches and Bronchial Artery Dilatation

Abstract

We report an elderly patient in whom a thrombus in the distal left pulmonary artery was shown by transesophageal echocardiography to extend and produce obstruction of the descending lobar branches as well as dilatation of the left bronchial artery.

Transesophageal Echocardiographic Finding of Bronchial Artery Dilatation in Chronic Obstructive Pulmonary Disease

“…A previous transesophageal echocardiographic (TEE) study from our laboratory demonstrated a prominent and dilated bronchial artery in an elderly patient with thrombotic obstruction of the left pulmonary artery 1 . We report similar findings in a patient with chronic obstructive pulmonary disease (COPD).…”

Transesophageal Echocardiographic Identification of Normal and Stenosed Posterior Intercostal Arteries

“…The proximal PICAs can be confused with the bronchial arteries, which may arise directly from the proximal descending aorta close to the arch. However, the flow pattern from the bronchial arteries 12,13 in our experience, is of low resistance type with prominent antegrade Doppler flow signals in both systole and diastole, unlike the PICAs that exhibit very low flow velocity signals in diastole (Figs. 1 and 2).…”

“…More recently, the technique has been used to identify the right common carotid, right subclavian, left internal mammary, bronchial, and the extracranial segments of both vertebral arteries. In addition, using the transpharyngeal approach, the proximal portions of both the right and left external and internal carotids have also been studied 1–14 . However, there is scant information in the literature regarding the TEE identification of other branches of the aorta, like the posterior intercostal arteries (PICA) 15 .…”