Two-Dimensional Echocardiographic Evaluation of the Thoracic Aorta

Abstract

Aortic coarctation is the most common form of congenital aortic arch obstruction. Using the suprasternal notch view, Sahn et al [1] detected the obstruction in eight of 15 patients with aortic coarctation. Weyman et al [2] detected the site of obstruction in 16 of 18 patients with coartation of the aorta. Similarly, Snider and Silverman [3] studied 37 patients with aortic coarctation; the 30 true positive studies were recorded in patients with gradients of 15–80 mmHg while the seven false negative studies were recorded in patients gradients of 5–25 mmHg. The characteristic features are a dilated proximal aorta and brachiocephalic vessels which are all grossly pulsatile. a discrete narrowing of the descending thoracic aorta, and diminished pulsation with post-stenotic dilation of the aorta distal to the coarctation (Figure 1). A false negative diagnosis is mostly related to technical factors, mild narrowings, and patient cooperation. A false positive study can be seen in patients with isthmic hypoplasia [1]. Other forms of aortic arch obtruction, such as total arch interruption, can be recorded using suprasternal notch two-dimensional echocardiography [3, 4].