Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Mar 1998
Comparative StudyThree-dimensional imaging in aortic disease by lighthouse transesophageal echocardiography using intravascular ultrasound catheters. Comparison to three-dimensional transesophageal echocardiography and three-dimensional intra-aortic ultrasound imaging.
Two-dimensional (2D) transesophageal echocardiography (TEE) and 2D intravascular ultrasound (IVUS) imaging face their greatest limitation in visualizing aortic disease in patients. With the aid of three-dimensional (3D) image reconstruction, TEE and IVUS can potentially overcome this limitation but still provide only limited spatial appreciation in aortic disease because 3D imaging of the thoracic aorta requires a broader spatial visualization of the mediastinum than provided by both techniques. Moreover, for timely decision making about aortic disease TEE is limited by a large probe, which requires sedation. ⋯ Spatial visualization of the aortic arch by 3D TEE was incomplete because of the relatively narrow 90-degree image sector. However, in other segments 3D image quality by 3D TEE was superior to 3D LTEE and 3D IVUS. Because of the thin catheter, patient discomfort (p < 0.0001) and examination time (p = 0.015) were significantly less for 3D LTEE compared with 3D TEE. 3D LTEE is a promising new technique for 3D imaging of the thoracic aorta and detection of aortic disease with improved spatial visualization and reduced patient discomfort compared with 3D TEE and 3D IVUS.
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J Am Soc Echocardiogr · Mar 1998
Case ReportsPseudoaneurysm of the ascending aorta after aortic valve replacement.
A 58-year-old man with fever and chest wall tenderness was seen 8 weeks after aortic valve replacement. His initial postoperative course had been complicated by mediastinitis, requiring antibiotics and surgical debridement. ⋯ Pseudoaneurysm of the ascending aorta was suspected, based on computerized tomographic and magnetic resonance images of the chest. Intraoperative transesophageal echocardiography confirmed the diagnosis of pseudoaneurysm and was a key component in the patient's operative management.