Use of transesophageal echocardiography in the evaluation of traumatic aortic injury

Paul A. Kearney, D. Wesley Smith, Steven B. Johnson, Donald E. Barker, Mikel D. Smith, Peter M. Sapin

Research output: Contribution to journalArticlepeer-review

85 Scopus citations

Abstract

Indications for aortography following blunt chest trauma are broad and ill-defined. This study prospectively assessed the role of transesophageal echocardiography (TEE) in the evaluation of suspected aortic injury. We used both TEE and aortography to evaluate 69 patients with suspected thoracic aortic injury. The studies were performed and interpreted by staff radiologists and cardiologists. The mean study time for TEE was 27 minutes, whereas the mean study time for aortography was 76 minutes (p < 0.05). No complications occurred with either procedure. Both TEE and aortography revealed no evidence of aortic injury in 61 patients. There was one false- positive aortogram. TEE identified seven aortic injuries; four were confirmed by aortography. One patient underwent thoracotomy and aortic repair based on TEE findings alone. Aortograms yielded false-negative results for two patients; one injury was confirmed at thoracotomy, the other at autopsy. TEE accurately predicted the presence or absence of aortic injury in each case, for a diagnostic sensitivity and specificity of 100%. TEE can be performed safely and efficiently on the multiple-injury patient. We conclude that TEE is useful in the evaluation of suspected aortic injury.

Original languageEnglish
Pages (from-to)696-703
Number of pages8
JournalJournal of Trauma
Volume34
Issue number5
DOIs
StatePublished - May 1993

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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