Vf. Chu et al., Transesophageal echocardiography for ascending aortic dissection: Is it enough for surgical intervention?, J CARDIAC S, 13(4), 1998, pp. 260-265
Background: Acute ascending aortic dissection is a surgical emergency that
requires expeditious diagnosis and prompt surgical intervention. In many ce
nters, transesophageal echocardiography (TEE) is the test of choice on whic
h surgical decisions are based. Echocardiographic False-positive diagnoses
are rare but can occur with potentially severe consequences. Case report: T
wo clinical cases where ascending aortic dissections were falsely diagnosed
by TEE are presented. Discussion: Recent literature comparing the diagnost
ic accuracy of TEE and other imaging techniques are reviewed. Anatomical li
mitations of TEE and potential causes of false-positive results are discuss
ed. Multiplane probe reduces, but does not eliminate, the occurrence of fal
se-positive findings. To improve diagnostic specificity without undue delay
s in the course of clinical decision making, we recommend dividing positive
IEE findings into "definite" and "probable" categories. Such subclassifica
tion is helpful in identifying cases where additional confirmatory tests ar
e desirable in situations of uncertain diagnosis.