Disease of the Aorta

Abstract

Echocardiography plays an essential role in the diagnosis, management plans, and follow-up of aortic diseases. Study of the aorta is a routine part of the standard echocardiographic examination. Transthoracic echocardiography (TTE) permits adequate assessment of several aortic segments, mainly the aortic root and the proximal ascending aorta. Transesophageal echocardiography (TEE) overcomes the limitations of TTE in the evaluation of the thoracic aorta. TEE must be used in a complementary manner. Echocardiography is useful and valuable for assessing the size, biophysical properties, and atherosclerotic involvement of the thoracic aorta. Although TEE is a useful method in the diagnosis of aortic dissection, TTE may be used as the initial modality in the emergency setting. Intimal flap in the proximal ascending aorta, pericardial effusion/tamponade, and left ventricular function can be easily visualized by TTE. Nonetheless, a negative TTE does not rule out aortic dissection and other imaging modalities should be considered. TEE must define entry tear location, mechanisms and severity of aortic regurgitation, and also true lumen compression. Additionally, echocardiography is crucial in selecting and monitoring surgical and endovascular treatment and in noticing possible complications. Even though other imaging techniques such as computed tomography and magnetic resonance imaging have a greater field of view and can yield complementary information, echocardiography is accurate, portable, rapid, and cost-effective in the diagnosis, management plans, and follow-up of most aortic diseases.