This preliminary study demonstrates the feasibility of examining the proximal segments of the branches of the left subclavian artery during probe withdrawal toward the end of a routine transesophageal echocardiographic study. The branches identified most commonly were the vertebral and the internal mammary arteries.
In the present study, we report our experience of using three-dimensional reconstruction of transesophageal two-dimensional echocardiographic images in the assessment of aortic dissection (22 patients), aortic rupture (1 patient), aortic aneurysm without dissection (2 patients), and aortic tumor (1 patient).
The present study demonstrates the feasibility of delineating the carotid bulb and the proximal portions of the left external and left internal carotid arteries during transesophageal examination. This was accomplished by slowly and carefully withdrawing the probe from the esophagus into the pharynx.
Traumatic rupture of aortic isthmus atherosclerotic plaque resulting in dissection has not been documented through the use of either invasive or noninvasive diagnostic modalities. We describe an elderly patient in whom transesophageal echocardiography and three-dimensional reconstruction of multiplane transesophageal two-dimensional images clearly demonstrated the traumatic dissection to be due to rupture of a large atherosclerotic plaque located in the aortic isthmus. The patient had experienced blunt trauma to the chest from the impact of the steering wheel during an automobile accident.
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