This study was designed to assess the sensibility, specificity and diagnostic accuracy of transesophageal echocardiography (TEE) and X-ray contrast enhanced computed tomography (CT) in the diagnosis of aortic dissection and its complications. Fifty patients with clinically suspected aortic dissection were examined. Imaging results were validated in each case by intraoperative and/or autopsy findings and/or the results of cineangiography. The Stanford and DeBakey classifications were used to differentiate the dissection type; the patients were also subdivided by TEE according to a modified DeBakey classification. The sensibility of TEE to detect aortic dissection was 100%, significantly higher (p < 0.05) than that of CT for type A dissections (77.2%). The two imaging procedures did not statistically differ (NS) in the detection of type B dissection (CT sensibility 87.5%). The specificity of TEE for the detection of type A aortic dissection was 94%; it was not significantly higher (NS) than that of CT (CT specificity 86.6%). Both TEE and CT had no false negative findings in the diagnosis of type B aortic dissection (100%; TEE vs CT, NS). TEE was reliable in the correct identification of the primary entry site in the ascending aorta (80%), the arch (62.5%) and descending aorta (71.4%), and also in the involvement of coronary arteries (62.5%), and aortic arch branch vessels (71.4%); CT scanning was not effective in detecting any of these complications. Aortic regurgitation was accurately identified by TEE in each case. Both TEE and CT scanning correctly identified thrombosis of the false lumen and pericardial effusion. Intraoperative TEE documented in all patients postrepair persistence of the intimal flap in aortic segments that were not operated; flow in the false lumen was detected in 46.6% of the patients; in 26.6% of them secondary tears, not seen before surgical treatment, were detected. In conclusion, TEE allows a bedside, safe and accurate diagnosis and classification of aortic dissection. It also provides the diagnostic information necessary for the therapeutical decision making. Intraoperative TEE allows improvement in preoperatory diagnosis and gives important information for the management of the patient immediately after cardiopulmonary bypass and in the follow-up.
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J Community Hosp Intern Med Perspect
November 2024
Department of Nursing, Karnali Academy of Health Science, Jumla, Nepal.
Infectious aortitis is an uncommon but potentially fatal condition that can lead to aortic dissection or rupture. We describe a case of a 69-year-old female who developed a Stanford type B aortic dissection, presumptively caused by Salmonella, which was successfully managed with thoracic endovascular aneurysm repair (TEVAR) and long-term antibiotics. A literature review of 17 reported cases from 2000 to 2024 of aortic dissection secondary to infectious aortitis was conducted.
View Article and Find Full Text PDFQuant Imaging Med Surg
January 2025
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background: The bolus tracking technique has been used for decades, yet still faces the challenging task of determining the optimal scanning time for individuals. Our study aimed to assess the feasibility of a novel bolus tracking method with a personalized post-trigger delay (PTD) to optimize scanning time and achieve optimized enhancement and contrast homogeneity in aortic computed tomography angiography (CTA).
Methods: Participants undergoing aortic CTA with bolus tracking were prospectively assigned to two different groups: Group A with a fixed 6-second PTD and Group B with a personalized PTD.
J Obstet Gynaecol Res
January 2025
Department of Obstetrics and Gynecology, School of Medicine, Jichi Medical University, Tochigi, Japan.
Medroxyprogesterone acetate (MPA) is a promising fertility-sparing treatment for early stage endometrial cancer; however, it has a high recurrence rate and is inferior to surgery. Although the site of recurrence is mostly the endometrium, we here report a case of metastatic recurrence to the para-aortic lymph node with endometrial recurrence despite a careful follow-up. A 31-year-old woman was diagnosed with grade 1 endometrioid carcinoma, stage IA without myometrial invasion.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
January 2025
Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA. Electronic address:
Objective: To determine the impact of hematocrit on adverse neurologic events after acute type A aortic dissection (ATAAD) repair under deep hypothermic circulatory arrest.
Design: Retrospective study of consecutive aortic surgeries from 2010 to 2021.
Setting: Single institution.
Anat Cell Biol
January 2025
Department of Anatomy and Neurobiology, College of Medicine and Health Sciences, National University of Science and Technology, Sohar, Oman.
During dissection of a 70-year-old male donor, several anatomical variations were observed, highlighted by a bilateral variant middle scalene muscle in the superolateral thoracic wall. The variant scalene muscle was traced from the transverse processes of cervical vertebrae to the fourth rib with a pronounced fascial slip. The elongated middle scalene muscle was thick in girth and abnormally wide at its insertion (56.
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