Hashimoto S, Kumada T, Kubo S, Tokunaga S, Tamaki S, Nishimura K, Yamazato A, Osakada G, Ban T, Kawai C
Department of Internal Medicine, Kyoto University.
J Cardiol. 1989 Jun;19(2):519-28.
Transesophageal Doppler echocardiography (TEDE) was performed in three patients with proven or suspected DeBakey type I and type III aortic dissection. Case 1: A 66-year-old woman, with DeBakey type I aortic dissection. Clear images of a widened dissected aorta and an intimal flap were obtained in both the ascending and descending aorta, including the aortic arch. The site of an entry into the false lumen was identified by the defect of the intimal flap and the pulsatile entry flow through it. The reentry into the true lumen was also identified near the orifice of the celiac trunk. In this case, the observation was performed using this technique during the operation; i.e., replacement of the ascending aorta with an artificial graft. Case 2: A 77-year-old man, DeBakey type III aortic dissection. The study was performed after surgery which consisted of replacement of the descending aorta with an artificial graft. TEDE provided clear images of the artificial graft, the aorta, and their boundaries. The remaining intimal flap was clearly confirmed. Case 3: An 80-year-old man, DeBakey type III aortic dissection. In this case, though abdominal echography suggested aortic dissection, angiography and X-ray CT failed to facilitate the diagnosis. Only TEDE confirmed the diagnosis. The abnormal flow via the entry directing toward the false lumen was clearly demonstrated on the color Doppler images. We therefore conclude that TEDE is a useful and reliable means of diagnosing dissecting aortic aneurysm.
对3例确诊或疑似I型和III型主动脉夹层的患者进行了经食管多普勒超声心动图（TEDE）检查。病例1：一名66岁女性，患有I型主动脉夹层。在升主动脉和降主动脉，包括主动脉弓，均获得了增宽的夹层主动脉和内膜瓣的清晰图像。通过内膜瓣的缺损以及穿过它的搏动性进入血流确定了进入假腔的部位。在腹腔干开口附近也确定了重新进入真腔的部位。在该病例中，在手术过程中使用该技术进行观察，即用人造血管置换升主动脉。病例2：一名77岁男性，患有III型主动脉夹层。该研究在用人造血管置换降主动脉的手术后进行。TEDE提供了人造血管、主动脉及其边界的清晰图像。明确证实了残留的内膜瓣。病例3：一名80岁男性，患有III型主动脉夹层。在该病例中，尽管腹部超声检查提示主动脉夹层，但血管造影和X线CT未能有助于诊断。只有TEDE确诊了该病。彩色多普勒图像清晰显示了经入口进入假腔的异常血流。因此，我们得出结论，TEDE是诊断主动脉夹层动脉瘤的一种有用且可靠的方法。
