Archive for the ‘Aortic’ Category

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Limitations

Because multiplane TEE probe was not available in all patients in protocol A, the additional diagnostic value of various tomographic planes for accurate identification of reverberation images was not specifically studied. However, most of the proposed diagnostic criteria may also be used in other TEE planes, as shown in Figure 7. In addition, because of […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Origins of Linear Artifacts

Using in vitro experiments, Appelbe et al confirmed the origin of multiple-path linear artifact by imaging two water-filled latex balloons of varying size placed in series in a water tank. A linear artifact was only observed within the balloon representing the ascending aorta when its size exceeded that of the second balloon representing the left […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Impact on TEE Accuracy

Although highly sensitive for the diagnosis of AD’’’’ and disrupted aortic isthmus,’ the major widely acknowledged drawback of TEE is its relatively poor specificity. Interestingly, this relative lack of specificity has been predominantly reported for the diagnosis of Stanford type-A AD, whereas TEE diagnostic specificity is usually higher when the dissecting process is confined to […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Discussion

In this study, we describe comprehensive TEE criteria that allow accurate differentiation between intra-aortic linear artifacts and true aortic flaps, resulting in improved diagnostic specificity. This may have a relevant clinical impact when considering the high prevalence of multiple-path artifacts noted in our cohort of patients undergoing a TEE to rule out an acute aortic […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Results Protocol B

Protocol B Among the 121 patients studied, 73 patients (60%) underwent the TEE study to rule out a spontaneous AD, while the remaining 48 victims of violent deceleration accidents (40%) were examined for suspected TDA. tadanafil Of 33 patients with proven AD, 14 patients (42%) sustained a Stanford type-A AD while the remaining 19 patients […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Results Protocol A

The TEE criteria found to be predictive of the presence of linear artifacts within the descending thoracic aorta are shown in Table 2. Both the thickness of linear artifacts and the angle between the aortic wall and the linear image tended to be larger than those noticed in true aortic flaps (3.3 ± 1.5 mm […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Results

Protocol A Among the 230 patients studied, 188 patients (82%) underwent TEE to rule out a spontaneous AD, while the remaining 42 patients (18%) were examined for a suspected TDA after sustaining severe blunt chest trauma. The TEE findings are summarized in Figure 2. Frequency of Aortic Flaps and Linear Artifacts: In the 81 patients […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Protocol B

Protocol B: All TEE studies were reviewed by the same investigators, who again were unaware of the final diagnoses. In each patient who exhibited an intra-aortic linear image, both investigators used the TEE diagnostic criteria established in protocol A to determine whether the linear image was an artifact or a true flap. The diagnostic accuracy […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Data Analysis

Protocol A: Two experienced observers blinded to both the clinical history and final diagnosis jointly reviewed the TEE studies. In each patient, the ascending and descending segments of the thoracic aorta were evaluated separately. The observers determined whether a persistent linear intra-aortic image was present or absent, using adequate gain settings. Accordingly, nonlinear artifacts such […]

Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption: Materials and Methods

Population and Study Design Between January 1991 and December 1998, 469 patients undergoing a TEE examination for suspected AD or TDA were recruited from two tertiary referral teaching hospitals (Du-puytren University Hospital, Limoges, France, and The University of Chicago Medical Center, Chicago, IL). Patients were excluded when the diagnostic confirmation of TEE findings was not […]

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