Transesophageal echocardiography after contrast-enhanced CT angiography in the diagnosis of type A aortic dissection.

Contrast-enhanced CT angiography (CTA) currently is considered the diagnostic modality of choice in the diagnosis of acute type A aortic dissection. However, pitfalls associated with acquisition and interpretation of CTA images may result in misdiagnosis. We present examples of false-positive and false-negative interpretations of CTA in emergency situations that underline the importance of intraoperative preincision transesophageal echocardiography (TEE) in the diagnosis and management of this highly lethal entity.