MOBILITY OF THE INTIMAL FLAP AND THROMBUS FORMATION IN AORTIC DISSECTION - A TRANSESOPHAGEAL ECHOCARDIOGRAPHIC STUDY

The mechanisms of the motion of the intimal flap and of thrombus forma tion in acute or chronic aortic dissection are not definitively elucid ated. Transesophageal echocardiography seems to be a technique of choi ce to analyze the flow in the true and false lumina. Twenty-one consec utive patients were studied in order to define the mobility of the int imal flap, the color Doppler flow patterns, the presence of spontaneou s echocardiographic contrast, and thrombus formation at different leve ls of the aorta. The results suggest that clotted false lumen is more often seen in chronic aortic dissection at the level of the descending thoracic aorta. However, thrombosed false lumen in the aortic arch is suggestive of a retrograde aortic dissection. In cases of complete ob literation of the false lumen, the differentiation between aortic diss ection and aortic ectasia with mural thrombus may be extremely difficu lt.