Diehl J T, Kaiser L R, Howard R J, Salerno T A
Can J Surg. 1985 Jul;28(4):345-7.
The diagnosis of type A aortic dissection (involving the ascending aorta) can be made with two-dimensional echocardiography, but surgeons usually demand angiographic confirmation. Between January 1983 and February 1984, 10 patients presented at St. Michael's Hospital in Toronto with type A aortic dissection. Six patients underwent two-dimensional echocardiography early in their evaluation. A positive diagnosis was made in four, based upon visualization of an intimal flap or a false lumen. In the other two patients, the findings of an enlarged ascending aorta and pericardial effusion were suggestive but not diagnostic. Three patients survived operation and are alive and well (follow-up ranging from 3 to 5 months). One patient died while awaiting surgery, one died during aortography and one died during operation. All echocardiographic and angiographic findings were confirmed at surgery or at autopsy. It is concluded that two-dimensional echocardiography can diagnose ascending aortic dissection quickly, accurately, easily and without risk to the patient. In selected cases the presence of a false lumen or of an intimal flap makes it possible to proceed with operation without delay or the potential hazards of aortography.
A型主动脉夹层（累及升主动脉）的诊断可通过二维超声心动图做出，但外科医生通常要求血管造影确认。1983年1月至1984年2月期间，10例A型主动脉夹层患者就诊于多伦多的圣迈克尔医院。6例患者在评估早期接受了二维超声心动图检查。4例根据内膜瓣或假腔的可视化做出了阳性诊断。在另外2例患者中，升主动脉增宽和心包积液的表现具有提示意义但不能确诊。3例患者手术存活，目前健康状况良好（随访时间为3至5个月）。1例患者在等待手术期间死亡，1例在主动脉造影时死亡，1例在手术期间死亡。所有超声心动图和血管造影结果均在手术或尸检时得到证实。结论是二维超声心动图能够快速、准确、简便地诊断升主动脉夹层，且对患者无风险。在某些病例中，假腔或内膜瓣的存在使得可以立即进行手术，而无需延迟或承担主动脉造影的潜在风险。
