Intraoperative transoesophageal echocardiography as an adjuvant to fluoroscopy during endovascular thoracic aortic repair

Objectives: to define the utility of intraoperative transeophageal echocard iography (TEE) during endovascular thoracic aortic repair. Design: retrospective study. Materials: five patients underwent six transluminal endovascular stent-graf t procedures for repair of thoracic aortic disease. Methods: after induction of anaesthesia, a multiplane or biplane TEE probe Was placed to obtain views of the diseased aorta. Both transverse and longi tudinal planes of the aortic arch and descending thoracic aortic se,aments were imaged. The aortic pathology was confirmed by TEE and the proximal and distill extents of the intrathoracic lesion Were defined. Doppler and colo ur-flow imaging was used to identify flow patterns through the aorta before and after stent-graft deployment. Results: visualisation and confirmation of the aortic pathology by ultrason ography was accomplished in all patients. TEE was able to confirm proper pl acement of the endograft relative to the aortic lesion after deployment and was able to confirm exclusion of blood flow into the aneurysm sacs. Conclusions: TEE may facilitate repair by confirming aortic pathology, iden tifying endograft placement, assessment of the adequacy of aneurysm sack is olation, as well as dynamic intraoperative mt-dine assessment.