P. Simon et al., TRANSESOPHAGEAL ECHOCARDIOGRAPHIC FOLLOW-UP OF PATIENTS WITH SURGICALLY TREATED AORTIC-ANEURYSMS, European heart journal, 16(3), 1995, pp. 402-405
In the present study, biplane transoesophageal echocardiography (TEE)
was scheduled as part of an aneurysm surveillance programme during rou
tine ambulatory follow-up of 37 patients following aortic aneurysm sur
gery. Time from surgery ranged from 3-72 months. Twenty-two patients h
ad had aortic dissection and 15 non-dissecting aneurysms. Nineteen pat
ients received an interposition graft of the ascending aorta, 12 valve
d conduit and six an interposition graft of the descending thoracic ao
rta. TEE showed enlargement of the sinus of Valsalva >45 mm in seven p
atients. Dilatation >45 mm of one or more aortic segments was found in
four patients. Art intimal flap tons present in all patients, with pr
imary aortic dissection if the initial dissection extended beyond the
replaced segment. This was the case in 17 of 22 patients with aortic d
issection. One to four intimal tears were identified in 15 of these pa
tients In all patients with intimal tears, flow was detected by colour
flow Doppler in the false lumen. Thrombus formation was nil or minima
l in the false lumen in 12 patients. TEE significantly influenced furt
her management in 14 of 37 patients (38%). More frequent follow-up was
scheduled in eight patients. Aortic surgery was performed electively
for the second or third lime in sh patients based on TEE findings. We
conclude that after surgical repair of aortic aneurysm, the incidence
of pathological findings by TEE is high. These may have significant in
fluence on further patient management and emphasize tile need for care
ful follow-up.