Aortic echocardiography

Riaz K, Forker AD, Garg M, McCullough PA. Atypical presentation of cocaine-induced type A aortic dissection a diagnosis made by transesophageal echocardiography. J 108. Investig Med 2002 50(2) 140-2. 

Aortic arch atheroma is now increasingly diagnosed by transesophageal echocardiography in patients with TIAs or ischemic stroke, but so far there are no surgical, or indeed medical, treatment options over and above controlling vascular risk factors and antiplatelet drugs. One trial of medical treatment has been started, the Aortic Arch Related Cerebral Hazard (ARCH) trial (MacLeod et al. 2004). 

Gramiak, R. and Shah, RM. 1970. Echocardiography of the normal and diseased aortic valve. Radiology 96 1. 

Sahasakul, Y., Edwards, W.D., Naessens, J.M., and Tajik, A. J. 1988. Age-related changes in aortic and mitral valve thickness implications for two-dimensional echocardiography based on an autopsy study of 200 normal human hearts. Am. J. Cardiol. 62 424-430. 

Gramiak R, Shah PM (1968) Echocardiography of the aortic root. Invest Radiol 3 356-366... 

Fig. 3 Changes in aortic valve peak velocity caused by valve stenosis recorded by echocardiography. Top panel Doppler image of the aortic valve of a young (2 months) ApoE mouse, which presents a peak velocity of 900 mm/s. Bottom panel the aortic stenosis of an aged ApoE mouse fed for three months with high fat diet results in a peak velocity on the order of 2200 m/s.

Cardiovascular In 63 liver transplant recipients, including 19 children, cardiovascular examinations, electrocardiography, and echocardiography after 3 months were normal, except for 2 children who developed tacrolimus-related cardiac complications [139 ]. One had hypertrophic obstructive cardiomyopathy and aortic valve stenosis and the other had aortic stenosis and mitral and tricuspid regurgitation. Both had high serum tacrolimus concentrations. 

Johnson DD, Pretorius DH, BudorickNE (2000) Fetal lip and primary palate three-dimensional versus two-dimensional US. Radiology 217 236-239 Kasprzak JD, Salustri A, Roelandt JR (1998) Three-dimensional echocardiography of the aortic valve feasibility, clinical potential, and limitations. Echocardiography 15 127-138... 

Echo has been used to assess aU levels of mechanical dyssynchrony dys-synchrony between the atrium and the ventricle, interventricular dyssynchrony, and intraventricular dyssynchrony. Echo Doppler imaging at the level of the mitral valve inflow shows the effects of a long AV interval (fused E and A waves with diastolic mitral regurgitation), short AV interval (truncation of A wave with loss of atrial kick), and optimal AV interval (aortic systolic flow starts at the end of A wave) (5,31). This is illustrated in Fig. 11.4. Pulsed-wave Doppler echocardiography has been used to evaluate interventricular dyssynchrony that is defined as the time difference between right and left ventricular pre-ejection intervals. This is usually measured from the onset of the QRS complex on the EKG (that correlates with the end of diastole) to the onset of the aortic and pulmonary ejection. Delayed aortic ejection time (>40-50ms) has been used as a marker of interventricular dyssynchrony that improves with CRT (32-34). 

Meyer TE, Sareh P, Marcus RH, Patel J, Berk MR. Beneficial effect of atrial pacing in severe acute aortic regurgitation and role of M-mode echocardiography in determining the optimal pacing interval. Am J Cardiol 1991 67 398-403. 

Pouleur AC, le Polain de Waroux JB, Pasquet A, Vanover-schelde JL, Gerber BL. (2007) Aortic valve area assessment multidetector CT compared with cine MR imaging and transthoracic and transesophageal echocardiography. Radiology 244 745 754... 

Tanaka H, Shimada K, Yoshida K, Jissho S, Yoshikawa J, Yoshi-yama M. (2007) The simultaneous assessment of aortic valve area and coronary artery stenosis using 16-slice multidetector-row computed tomography in patients with aortic stenosis comparison with echocardiography. Circ J 71 1593-1598... 

The measurement of valve orifice area (most often applied for aortic valve disease) can be applied to both techniques, CT and MW. Based on systolic images within the valvular plane, the outline of the valve orifice can be traced to evaluate the orifice area. The results of both methods show close correlation in comparison to echocardiography (Feuchtner et al. 2006b, 2007 Pouleur et al. 2007b). The measurement of the residual opening area in the setting of valve closure has also been used in CT imaging in order to assess and... 

Gelfand EV et al. (2006) Severity of mitral and aortic regurgitation as assessed by cardiovascular magnetic resonance optimizing correlation with Doppler echocardiography. J Cardiovasc Magn Reson 8 503 507... 

Morphologically, there are fusiform aneurysms (synonymous with circumferential) and sacciform aneurysms, which lead only to a partial dilatation of the aortic wall (Isselbacher 2005). The most common examinations for clinical diagnostics of TAA include echocardiography, MDCT, and MRl (Rubin and Kalra 2006). CTA of the aorta provides a clear visualization of the diameter and allows an evaluation of the relative position of the aneurysm to the neighboring anatomic structures (Fig. 23.5). Dystrophic calcifications of thrombi adherent to the aortic wall can sometimes simulate a dissection of the aortic wall. In the case of a suspected leakage of the aneurysm, an additional nonenhanced scan is recommended in order to detect a periaortic hematoma. 

To rule out a concomitant insufficiency of the aortic valve, echocardiography or MRI may be necessary. Be-... 

Dangerous comphcations like aortic rupture, pericardial tamponade, or hemothorax can be identified easily by CT. However, echocardiography or MRI is required in order to determine the function of the valves. 

Mohr-Kahaly S, Erbel R, Kearney P, Puth M, Meyer J (1994) Aortic intramural hemorrhage visualized by transesophageal echocardiography findings and prognostic implications. J Am Coll Cardiol 23 658 664... 

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