FURTHER EXPERIENCE WITH TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE EVALUATION OF THORACIC AORTIC INJURY

This prospective study sought to further define the role of transesoph ageal echocardiography (IEE) in diagnosing thoracic aortic injury. We performed TEE, aortography, or both on 160 consecutive patients suspec ted of having blunt thoracic aortic injury: TEE correctly identified 1 4 aortic injuries, of which five were confirmed by aortography, seven at thoracotomy, and two at autopsy. The TEE results were suggestive of but not diagnostic for injury in two additional patients with proven aortic injury, and TEE was otherwise 100% sensitive and specific for a ortic injury. Aortograms yielded one false positive result and four fa lse negative results, for a sensitivity of 73% and a specificity of 99 %. We conclude that TEE is a rapid, safe, and accurate bedside method for evaluating the heart and thoracic aorta for blunt trauma. Negative or positive TEE results obviate the need for aortography. We recommen d that aortography be used when TEE results are equivocal, when TEE is not tolerated or contraindicated, or when other suspected vascular in juries require evaluation by arteriography.