Usefulness of transesophageal echocardiography in assessment of aortic dissection.

Ballal, Raj S.; Nanda, Navin C.; Gatewood, Robert P.; D’Arcy, Brian; Samdarshi, Tandaw E.; Holman, William L.; Kirklin, James K.; Pacifico, Albert D.

doi:10.1161/01.cir.84.5.1903

Cited by 187 publications

(48 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 Compared with CT scanning and angiography, transesophageal echocardiography has increased sensitivity and specificity for the diagnosis of aortic dissection. 3 In both of our reported cases, TEE was able to exclude the diagnosis of aortic dissection with certainty.…”

Section: Discussionmentioning

confidence: 50%

The role of transesophageal echocardiography in the acute onset of paraplegia.

Walsh

Uppal

Karalis

et al. 1992

Stroke

View full text Add to dashboard Cite

Background and Purpose: Acute paraplegia must be investigated promptly to exclude reversible causes. In this report we illustrate the usefulness of transesophageal echocardiography in identifying the vascular etiologies of acute paraplegia.Case Descriptions: Two patients presented with acute paraplegia, one spontaneously and the other after removal of an intra-aortic balloon pump catheter. Through the use of transesophageal echocardiography, we excluded aortic dissection and identified protruding atherosclerotic plaques in the descending thoracic aorta of each patient. Embolization of atheromatous material from the thoracic aorta was considered the most likely etiology of paraplegia in both cases.Conclusions: Embolization from atherosclerotic plaques in the thoracic aorta may be an underestimated cause of acute paraplegia. Transesophageal echocardiography provides a safe, rapid, and reliable tool for investigating a vascular etiology of acute paraplegia. T he causes of acute paraplegia include malignant metastases to the spinal cord, trauma, aortic dissection, and spinal artery occlusion from thrombosis and embolism. Identification of the etiologic mechanism of acute paraplegia is not difficult when dealing with trauma or malignancies; for example, a magnetic resonance imaging (MRI) scan can quickly identify a compressive lesion. However, identifying a vascular etiology can be more challenging. Angiography has been the standard diagnostic test when a vascular cause, especially an aortic dissection, is suspected. However, less-invasive techniques such as transesophageal echocardiography (TEE) have been shown to be as reliable as angiography. In this report, we describe two patients with acute paraplegia in whom TEE was useful for demonstrating the probable etiology for the acute paraplegia. Case Reports Case 1A 77-year-old woman with a history of hypertension and coronary artery disease was admitted to a local hospital with sudden onset of epigastric pain radiating to her back, followed by paraplegia. Aortic dissection was suspected, and an emergency computed tomographic (CT) scan was performed and interpreted as normal. Upon transfer to our institution, her neurological examination was significant for sensory deficits at the T12 level on the left and at the T4 level on the right, with areflexia and marked motor weakness of her lower extremities.

show abstract

Section: Discussionmentioning

confidence: 50%

The role of transesophageal echocardiography in the acute onset of paraplegia.

Walsh

Uppal

Karalis

et al. 1992

Stroke

View full text Add to dashboard Cite

show abstract

“…Even though several case reports in which this condi- ─ 249 ─ Intraoperative TEE is also very useful for estimating both cardiac function and valve function 4) . Moreover, TEE is very useful for the assessment of aortic dissection 14) . In the first case, at the time of cardiopulmonary bypass weaning, intra-aortic balloon pumping and percutaneous cardiopulmonary support were ad- .…”

Section: Discussionmentioning

confidence: 99%

Acute Type A Aortic Dissection Involving Malperfusion of Bilateral Coronary Arteries

et al. 2017

View full text Add to dashboard Cite

“…When intimal flap is swung proximally, coronary artery flow may be compromised. [6][7][8] When it is swung distally, aortic arch vessels may be obstructed, and cerebral malperfusion may ensue. 9) In general, patients with this type of tear are critically ill and require an emergency surgery, which carries a very high operative mortality of 40%.…”

Section: Discussionmentioning

confidence: 99%