Introduction and objective: Eighty-two patients with suspected aortic dissection were studied to assess the usefulness of transesophageal echocardiography in the diagnosis of this entity.
Methods: All patients underwent transesophageal echocardiogram. The diagnosis of aortic dissection was established in 46 patients by other diagnostic procedures including angiography and computed tomography, surgery and necropsy.
Results: The sensitivity and specificity of transesophageal echocardiography were 98% and 97%, respectively. By computed tomography, sensitivity was 92% and specificity 88%. By angiography, sensitivity and specificity were 97% and 93%, respectively. In the diagnosis of the dissection type, transesophageal echocardiography classified correctly in 98%, computed tomography in 89% and angiography 97% of cases. Transesophageal echocardiography visualized the tear in 82% of cases, and angiography in 53%.
Conclusions: Transesophageal echocardiography provides rapid, accurate diagnosis of aortic dissection and permits the initiation of appropriate treatment. Angiography is indicated in non-conclusive cases or those which supra-aortic involvement clinically suspected.