RT Book, Section
A1 Swaminathan, Madhav
A1 Mathew, Joseph P.
A2 Mathew, Joseph P.
A2 Nicoara, Alina
A2 Ayoub, Chakib M.
A2 Swaminathan, Madhav
SR Print(0)
ID 1171726985
T1 Aortic Surgery and Atheroma Assessment
T2 Clinical Manual and Review of Transesophageal Echocardiography, 3e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071830232
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1171726985
RD 2024/04/19
AB Aortic  diseases  can  range  from  apparently  innocuous  atherosclerosis  to  complex  aneurysmal  pathology.  Regardless  of  the  type  of  disease,  the  involvement  of  aortic  pathology  in  any  surgical  plan  can  present  a  challenge  to  both  surgeons  and  anesthesiologists.  Whereas  significant  atherosclerosis  at  critical  locations  can  alter  surgical  plans,  aortic  dissections  can  rupture  and  are  life  threatening,  require  rapid  and  accurate  diagnosis,  and  need  definitive  medical  and/or  surgical  management  due  to  their  high  risk  of  morbidity  and  mortality.1,2  A  key  ingredient  in  the  efficient  management  of  these  patients  is  imaging  of  the  thoracic  aorta.  The  anatomical  juxtaposition  of  the  esophagus  and  aorta  makes  transesophageal  echocardiography  (TEE)  an  attractive  imaging  tool.  It  is  now  recognized  as  an  essential  noninvasive  diagnostic  modality  for  acute  thoracic  aortic  pathologies,  and  is  a  standard  part  of  the  echocardiographer's  armamentarium  in  the  operating  room.3–6  In  emergent  situations,  TEE  may  be  the  only  imaging  modality  available.  It  is  therefore  important  for  the  echocardiographer  to  quickly  and  accurately  verify  the  diagnosis,  distinguish  true  pathology  from  the  many  common  confounding  artifacts,  and  clearly  communicate  precise  echocardiographic  findings  of  the  aorta  and  related  cardiac  anatomy  to  the  surgeon  to  guide  intervention.  The  following  text  reviews  aortic  anatomy  and  pathology  and  associated  echocardiographic  features  that  assist  with  imaging  during  aortic  surgery.