Evaluation of transeesophageal echocardiography in locating intimal fenestration and side branch involvement in acute aortic dissection.

概要

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The purpose of this study was to assess the diagnostic accuracy of biplane transesophageal echocardiography (TEE) in locating intimal fenestration and side branch involvement in aortic dissection. Sixty-nine patients (39 men and 30 women) aged 41-81 years with proven aortic dissection, who were reffered for surgical therapy, were examined by TEE during the acute phase. The defect's entry site was indentified either as a high velocity color Doppler flow issueing from a false lumen into a true lumen or estimated by the aortic portion where the false lumen flow originated. We attempted to visualize the aortic valves, the coronary areteries and the aortic arch vessels and to examine side branch involvement. Intraoperative inspection of the aorta was performed. The sensitivity of TEE was calculated from the percent of validated true positives. The sensitivities of TEE for an entry site and involvements of aortic valves, coronary arteries and aortic arch vessels were 90%, 85%, 83% and 63%, respectively. TEE is an excellent method for evaluating entry site and side branch involvement except for parts of the aortic arch vessels when acute aortic dissection has occurred.
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