Transesophageal echocardiography was performed in 25 patients with the clinical suspicion of an aneurysm or dissection of the thoracic aorta. The results obtained were compared to those of conventional transthoracic echocardiography. An aortic dissection was found in 11 patients, an aortic aneurysm in 9 patients, and an aneurysm of the left subclavian artery, an abscess of the aortic ring and a perforated aortic sinus in one patient each. In 2 patients no abnormalities of the thoracic aorta could be found. The intimal flap was detected in 11 patients with transesophageal imaging and in 9 patients with the transthoracic approach. Aortic dissection was suspected in another 5 patients with transthoracic echocardiography which could be excluded by transesophageal echocardiography. In 13 patients (52%) imaging of the descending thoracic aorta was not possible with transthoracic echocardiography but in all patients it was possible from the transesophageal approach. Transesophageal echocardiography seems to be a useful diagnostic approach when diseases of the thoracic aorta were clinically suspected.

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