Diagnosis of dissecting aortic aneurysm by two dimensional echocardiography: experience with 58 patients

Recent improvements in surgical technics have dramatically changed the outcome of patients with aortic dissection (AD). The aim of this work is to evaluate the reliability of two dimensional echocardiography (2DE) in the diagnosis of AD. The 2DE was recorded in all patients with a systematic approach in order to visualize the entire aorta (Ao). 58 cases were studied in a three years period. At the beginning of this study we validate 2DE by comparison with angiography (angio) in 14 of our first patients: the 2 angio criteria (dilatation, abnormal intraluminal image) have been found on 2DE in 12 pts (92%), with intraluminal image) have been found on 2DE in 12 pts (92%), with no significant difference between internal diameter of Ao on angio and 2DE. In our experience with 58 pts a positive diagnosis was possible in 90% of AD type I and only 18% of AD type III.

2DE is a practical and valuable method for the assessment of type I and II AD. Two 2DE criteria must be present at the same anatomical level (dilatation, abnormal intraluminal echo). In these conditions we have been able to avoid aortography in 26 of our last patients with type I and II.