Usefulness of transesophageal echocardiography in assessment of aortic dissection.
BACKGROUND
The value of transesophageal echocardiography in the assessment of patients with aortic dissection was studied.


RESULTS
Group 1 (34 patients) represented all patients studied at our institution with this technique in whom aortic dissection was proven by aortography, surgery, or autopsy. Group 2 (27 patients) represented all patients studied with this technique at our institution in whom aortic dissection was excluded by aortography. Transesophageal echocardiography made a correct diagnosis of aortic dissection in 33 of 34 patients (sensitivity, 97%; specificity, 100%). It also correctly demonstrated the type of dissection in all 29 patients with aortographic or surgical proof. On the other hand, computed tomography scanning, performed in 24 of 34 patients in group 1, made a correct diagnosis in only 67% of patients and misclassified the type of dissection in 33%. Transesophageal echocardiography correctly identified involvement of the coronary arteries by aortic dissection in six of seven patients as well as absence of both left and right coronary artery involvement in 10 patients with aortic dissection. This technique was also useful in detecting communications between the true and false lumens, presence of thrombi in the false lumen, and, in two patients, localized dissection rupture with formation of a false aneurysm. In both groups 1 and 2, transesophageal echocardiography correctly identified patients with moderate to severe aortic regurgitation.


CONCLUSIONS
Transesophageal echocardiography is very useful in the assessment of aortic dissection.
Department of Medicine, University of Alabama, Birmingham 35294.
R S
RS
Ballal
N C
NC
Nanda
R
R
Gatewood
B
B
D'Arcy
T E
TE
Samdarshi
W L
WL
Holman
J K
JK
Kirklin
A D
AD
Pacifico
D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging; D001027:Aortography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed