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Diseases of the aorta 

Diseases of the aorta
Diseases of the aorta

Arturo Evangelista

and T. González-Alujas

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date: 09 December 2021

Evaluation of the aorta is a routine part of the standard echocardiographic examination, because echocardiography plays an important role both in the diagnosis and follow-up of aortic diseases. In particular, echocardiography is useful for assessing aorta size, biophysical properties, and atherosclerotic involvement of the thoracic aorta.

Transthoracic echocardiography (TTE) permits adequate assessment of several aortic segments, particularly the aortic root and proximal ascending aorta. Transoesophageal echocardiography (TOE) overcomes the limitations of TTE in thoracic aorta assessment, so TTE and TOE should be used in a complementary manner.

Although TOE is the technique of choice in the diagnosis of aortic dissection, TTE may be used as the initial modality in the emergency setting. Intimal flap in proximal ascending aorta, pericardial effusion/tamponade, and left ventricular function can be easily visualized by TTE. However, a negative TTE does not rule out aortic dissection and other imaging techniques must be considered. TOE should define entry tear location, mechanisms of aortic regurgitation, and true lumen compression.

In addition, echocardiography is essential in selecting and monitoring surgical and endovascular treatment and in detecting possible complications. Although other imaging techniques have a greater field of view, echocardiography is portable, rapid, accurate, and cost-effective in the diagnosis and follow-up of most aortic diseases.

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