Intraoperative diagnosis of aortic dissection using transesophageal echocardiography

Abstract

U NLIKE transthoracic echocardiography, the transesophageal approach provides an excellent view of the thoracic aorta along with more consistently adequate views of the cardiac structures.rJ The increasing use of transesophageal echocardiography (TEE) by anesthesiologists to monitor cardiac function during cardiac and aortic surgery provides the opportunity to gain expertise in assessing normal aortic anatomy and pathology.’ Dissections of the aorta may occur acutely during cardiac surgery.J.5 The diagnosis is usually made by observation of a hematoma in the aortic wall or by the occurrence of profound hypotension when a femoral arterial perfusion cannula is used.” Use of TEE to evaluate intraoperative aortic dissections after the clinical diagnosis was made has been described.’ This article reports the use of TEE in two patients to immediately diagnose intraoperatively aortic dissections, allowing appropriate therapy.