Dataset Information

Detection of inadvertent passage of guide wire into the false lumen during thoracic endovascular aortic repair of Type B aortic dissection by transesophageal echocardiography.

ABSTRACT:

Background

Thoracic endovascular aortic repair (TEVAR) has become a widely accepted treatment strategy for patients with thoracic aortic pathologies. We present a case of TEVAR where transesophageal echocardiography (TEE) played a crucial role for adequate placement of an endovascular stent graft.

Case presentation

A 71-year-old male received TEVAR for type B aortic dissection. TEE detected both true/false lumens with an intimal tear. A guidewire was inserted into the descending aorta via the left femoral artery; however, angiography failed to identify the precise location of the tip of the guidewire. TEE detected the guide wire passing through the intimal tear into the false lumen, promoted the surgeon to manipulate and advance it to the true lumen, followed by placement of a stent graft. The patient was hemodynamically stable through the whole procedure.

Conclusion

TEE was crucially important for detecting the precise location of the guidewire and preventing complications during TEVAR.

SUBMITTER: Eissa M

PROVIDER: S-EPMC9287524 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Detection of inadvertent passage of guide wire into the false lumen during thoracic endovascular aortic repair of Type B aortic dissection by transesophageal echocardiography.

Eissa Mohamed M Mir-Ghassemi Asadollah A Nagpal Sudhir S Talab Hesham F HF

JA clinical reports 20220716 1

<h4>Background</h4>Thoracic endovascular aortic repair (TEVAR) has become a widely accepted treatment strategy for patients with thoracic aortic pathologies. We present a case of TEVAR where transesophageal echocardiography (TEE) played a crucial role for adequate placement of an endovascular stent graft.<h4>Case presentation</h4>A 71-year-old male received TEVAR for type B aortic dissection. TEE detected both true/false lumens with an intimal tear. A guidewire was inserted into the descending a ...[more]

PMID: 35840820

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Project description:Background Accurate assessment of the aortic annulus (AA) dimension and judgment of thoracic aorta aneurysm is crucial for patients with aortic regurgitation (AR) before surgery. The aim of this study was to evaluate the accuracy and reproducibility of three-dimensional transesophageal echocardiography (3D-TEE) methods for AA measurement and explore the predictive value of the AA dimensions obtained by 3D-TEE for high-risk thoracic aorta aneurysms using the gold standard of multi-slice computed tomography (MSCT). Methods 3D-TEE was performed on 111 patients with pure moderate-to-severe AR, and MSCT examination was conducted simultaneously. AA dimensions were obtained using reconstruction software for these two imaging techniques. Thoracic aortic diameters at standard anatomic landmarks were also measured by MSCT. All patients were divided into two groups depending on the presence of high-risk thoracic aorta aneurysms. Results Compared to MSCT, 3D-TEE overestimated all AA parameters. However, no statistically significant differences were found in the average bias between methods (minimum diameter: 26.07±3.57 vs. 25.88±3.68 mm, P=0.52; maximum diameter: 32.30±2.68 vs. 31.78±4.06 mm, P=0.11; area: 669.76±155.19 vs. 660.05±168.28 mm2, P=0.44; perimeter: 93.52±10.42 vs. 92.26±11.71 mm, P=0.12). 3D-TEE demonstrated good correlations with MSCT measurement for AA minimum diameter, maximum diameter, area, and perimeter (r=0.63, 0.64, 0.74, 0.69, P<0.05 for all). According to the multivariate logistic regression analysis, the AA minimum diameter obtained by 3D-TEE was the best predictor for the presence of high-risk thoracic aorta aneurysms. The sensitivity and specificity for prediction were 84.6% and 63.9%, respectively, for an AA minimum diameter ≥25.74 mm (AUC: 0.759, 95% CI: 0.668–0.850). Conclusions AA measurements obtained by the 3D-TEE method are feasible and reliable for patients with pure AR. The AA minimum diameter measured by 3D-TEE can effectively predict the presence of high-risk thoracic aorta aneurysms.

Dataset Information

Detection of inadvertent passage of guide wire into the false lumen during thoracic endovascular aortic repair of Type B aortic dissection by transesophageal echocardiography.

Background

Case presentation

Conclusion

Publications

Detection of inadvertent passage of guide wire into the false lumen during thoracic endovascular aortic repair of Type B aortic dissection by transesophageal echocardiography.

Similar Datasets

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