Aorta

Abstract

Even though many noninvasive imaging modalities are now available for evaluation of the thoracic aorta, transthoracic two-dimensional (2D) echocardiography is still used as a first-line-screening tool for diagnosing aortic pathology. However, transthoracic 2D echocardiography does not always achieve an ideal view of the entire thoracic aorta due to the limited acoustic window and factors related to patient habitus, and cannot definitively exclude aortic pathology. Other imaging modalities, such as multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging may be required for definitive diagnosis. Transesophageal echocardiography (TEE) yields higher temporal and spatial resolution images of the aorta than transthoracic echocardiography. TEE can be used in the emergency room and the operating theater to provide real-time information regarding primary pathologies and their related complications. Real-time three-dimensional (3D) TEE has now been available for more than 5 years, and the use of this modality is rapidly expanding. Although transducer technology still needs further refinement and 3D image quality depends on the expertise of the operator and the habitus of the patient, recognition of aortic structures using 3D imaging is intuitive, enabling easy visualization of abnormalities and of the surrounding structures. In this chapter, we describe the clinical utility of 3D TEE for the assessment of the thoracic aorta.