TRANSESOPHAGEAL ECHOCARDIOGRAPHIC FOLLOW-UP OF PATIENTS WITH SURGICALLY TREATED AORTIC-ANEURYSMS

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.