Survey of observer variation in transesophageal echocardiography: comparison of anesthesiology and cardiology literature

Shiga, Toshiya; Wajima, Zen’ichiro; Inoue, Tetsuo; Ogawa, Ryo

doi:10.1016/s1053-0770(03)00146-0

Cited by 14 publications

(5 citation statements)

References 123 publications

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“…However, the quality of TOE examination depends on the observer and their experience. False positive or false negative findings can arise easily when interpreted by unskilled individuals or a single person [47]. It also suffers from the poor spatial resolution and blind spots caused by intervening anatomical structures (fig.…”

Section: Diagnosis By Clinical Assessment and Imagingmentioning

confidence: 99%

Acute aortic dissection: pathogenesis, risk factors and diagnosis

Schönrath²,

2017

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Acute aortic dissection is a rare but life-threatening condition with a lethality rate of 1 to 2% per hour after onset of symptoms in untreated patients. Therefore, its prompt and proper diagnosis is vital to increase a patient's chance of survival and to prevent grievous complications. Typical symptoms of acute aortic dissection include severe chest pain, hypotension or syncope and, hence, mimic acute myocardial infarction or pulmonary embolism. Advanced age, male gender, long-term history of arterial hypertension and the presence of aortic aneurysm confer the greatest population attributable risk. However, patients with genetic connective tissue disorders such as Marfan, Loeys Dietz or Ehlers Danlos syndrome, and patients with bicuspid aortic valves are at the increased risk of aortic dissection at a much younger age. Imaging provides a robust foundation for diagnosing acute aortic dissection, as well as for monitoring of patients at increased risk of aortic disease. As yet, easily accessible blood tests play only a small role but have the potential to make diagnosis and monitoring of patients simpler and more cost-effective.

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Section: Diagnosis By Clinical Assessment and Imagingmentioning

confidence: 99%

Acute aortic dissection: pathogenesis, risk factors and diagnosis

Schönrath²,

2017

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“…More detailed information is obtained with TEE, especially for detection of pericardial effusion and aortic valve regurgitation, and often identification of the primary intimal tear in the aortic root. In expert hands, TEE is a powerful diagnostic tool, and its sensitivity and specificity approach 100% [52,53]. Coronary angiography is not indicated as a primary diagnostic method for ATAAD, but sometimes it is detected at coronary angiography, when acute coronary syndrome (ACS) is initially suspected.…”

Section: Diagnosismentioning

confidence: 99%

Acute type A aortic dissection – a review

Guðbjartsson

Ahlsson

Geirsson

et al. 2019

Scandinavian Cardiovascular Journal

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Acute type A aortic dissection (ATAAD) is still one of the most challenging diseases that cardiac surgeons encounter. This review is based on the current literature and includes the results from the Nordic Consortium for Acute Type-A Aortic Dissection (NORCAAD) database. It covers different aspects of ATAAD and concentrates on the outcome of surgical repair. The diagnosis is occasionally delayed, and ATAAD is usually lethal if prompt repair is not performed. The dynamic nature of the disease, the variation in presentation and clinical course, and the urgency of treatment require significant attentiveness. Many surgical techniques and perfusion strategies of varying complexity have been described, ranging from simple interposition graft to total arch replacement with frozen elephant trunk and valve-sparing root reconstruction. Although more complex techniques may provide long-term benefit in selected patients, they require significant surgical expertise and experience. Short-term survival is first priority so an expedited operation that fits in with the surgeon's level of expertise is in most cases appropriate. ARTICLE HISTORY Definitions and classification systemsDissection of the aorta occurs when the aortic media is separated, usually by pulsatile flow that penetrates the intimal layer of the aortic wall [14] (Figure 1(b)). This allows blood to flow between the layers of the aortic wall, forcing the layers apart, creating a false lumen parallel to the native (i.e. true) aortic lumen (Figure 1(b)). Consequently, the false lumen can propagate in both directions from the tear of intima and affect most of its distal branches, including the coronary, cerebral, and mesenteric arteries [15]. Another-but less common-CONTACT Tomas Gudbjartsson

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“…2 Generally, TEE examination tends to be somewhat observer and experience dependent, and false-positive or falsenegative findings can arise easily when data are interpreted by unskilled or single observers. 26 In patients with esophageal varices, TEE is contraindicated.…”

Section: Transesopghageal Echocardiographymentioning

confidence: 99%