Two-dimensional echocardiographic evaluation of aneurysms of the descending thoracic aorta

To determine the ability of two-dimensional echocardiography (2-D echo) to detect aneurysms and dissections of the descending thoracic aorta (DTA), we studied 15 patients, five with proved DTA dissections (group A) and 10 with proved aneurysms without dissection (group B), using 2-D echo in three recording positions: precordial, suprasternal and a modified apical. The DTA was visualized in 14 of 15 patients (93%); in each patient in group A, an intimal flap was recognized (in two patients only by the apical approach and in one patient by all approaches). The DTA was visualized in nine of 10 patients in group B; in each patient, the internal dimension of the DTA was enlarged (25-43 mm/m2). In one group B patient, aortic dissection was erroneously suspected because spurious echoes were present in the lumen; in another patient, 2-D echo failed to demonstrate a thrombotic stratification in the enlarged lumen. We conclude that 2-D echo using all available approaches appears to be a reliable technique for evaluating dissections and aneurysms of the DTA.