Application of intraoperative transesophageal echocardiography for occluding the rupture of aortic sinus aneurysm by cardiac interventional therapy via mini-thoracotomy

Abstract

Objective To assess the application of intraoperative transesophageal echocardiography for occluding the rupture of aortic sinus aneurysm(RASA) by cardiac interventional therapy via mini thoracotomy. Methods After anesthesia transesophageal echocardiography (TEE) was performed in patients with RASA to confirm or correct primary diagnosis from transthoracic echocardiography(TTE) and to predict the operative effect. During the operation the guide wire and Sheath pipe were accurately guided into rupture mouth of aortic sinus aneurysm by TEE. After the operation, the position of closure and the function of aortic valve need to check carefully. Results Collection of 38 patients with aortic sinus aneurysm rupture, 20 patients who can be received interventional therapy were select by TEE. Sixteen patients accepted interventional treatment successfully, including 8 cases with non-coronary sinus tumor to break into the right atrium, 5 cases with non-coronary sinus tumor to break into the right ventricle, and 3 cases with right coronary sinus tumor to break into the right ventricular outflow tract (3 cases). The patients who received intervention treatment successfully had stable vital signs, and no obvious changes of heart cavity structure and cardiac function in normal. Postoperative multiple reexamination, all patients showed the normal closure position, aortic valve opening and closing movement. And no stenosis and reflux signal, no residual shunt was detected. Conclusions TEE can confirm or correct primary diagnosis of TTE before the operation and guide the surgery operator to place the closure correctly during the operation and evaluate the effect of the treatment after the operation. Key words: Echocardiography, transesophageal; Aortic sinus aneurysm; Aneurysm, ruptured