[Two-dimensional echocardiographic diagnosis of aortic arch by suprasternal approach (author's transl)]

Two-dimensional echocardiographic studies of the aortic arch and proximal descending aorta were performed in 6 cases with coarctation of the aorta, 40 normal subjects and 9 cases of coarctectomy approached by the suprasternal notch. In cases with the normal aortic arch and proximal descending aorta, the ascending aorta, aortic arch, descending aorta and right pulmonary artery were visualized clearly. The diameter of the aortic lumen is consistent throughout the plane of the scan. The origins of the left carotid artery and the left subclavian artery were seen clearly. In 3 of 7 normal newborns a localized area of a slightly aortic narrowing (diameter of aortic narrowing area / diameter of proximal descending aorta greater than 0.75) was visualized. In 5 of 6 cases with coarctation of the aorta a localized area of an aortic narrowing distal to the origin of the left subclavian artery is visualized which corresponded to the angiographic appearance of the coarctation. In 1 of 6 cases with coarctation of the aorta a more diffuse area of aortic obstruction beginning from distal portion of the left carotid artery to distal portion of the left subclavian artery was visualized. In this case, aortic valve stenosis, ventricular septal defect, patent ductus arteriosus, and hypertrophy of the interventricular septum and left ventricular posterior wall were associated. In 9 coarctectomy cases a localized area of an aortic narrowing distal to the origin of the subclavian artery was enlarged after operation. Two-dimensional echocardiogram approached by the suprasternal notch may offer a useful noninvasive method for direct visualization of the aortic arch and proximal descending aorta.