Left Brachiocephalic Vein Mimicking an Aortic Dissection on Transesophageal Echocardiography

Abstract

Transesophageal echocardiography has gained widespread acceptance for the diagnosis of aortic dissection; however, little attention has been paid to the pitfalls that may be encountered. The left brachiocephalic vein can mimic a localized aortic dissection. The features that distinguished this vein from an aortic dissection are: the lack of the characteristic oscillating motion of an intimal flap; the pattern of flow within the vein; the tubular nature of the vein is seen using the sagittal imaging plane; and an injection of agitated saline into a left arm vein will show contrast enhancement of the left brachiocephalic vein.