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Titolo:
TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE DIAGNOSIS OF TRAUMATIC RUPTURE OF THE AORTA
Autore:
SMITH MD; CASSIDY JM; SOUTHER S; MORRIS EJ; SAPIN PM; JOHNSON SB; KEARNEY PA;
Indirizzi:
UNIV KENTUCKY,MED CTR,DIV CARDIOL,RM MN670,800 ROSE ST LEXINGTON KY 40536 UNIV KENTUCKY,DEPT INTERNAL MED,DIV CARDIOVASC MED LEXINGTON KY 00000 UNIV KENTUCKY,DEPT SURG,TRAUMA & CRIT CARE SECT LEXINGTON KY 00000 VET AFFAIRS MED CTR LEXINGTON KY 00000
Titolo Testata:
The New England journal of medicine
fascicolo: 6, volume: 332, anno: 1995,
pagine: 356 - 362
SICI:
0028-4793(1995)332:6<356:TEITDO>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLUNT CHEST TRAUMA; THORACIC AORTA; ANATOMIC CORRELATIONS; CLINICAL-APPLICATIONS; 10-YEAR EXPERIENCE; DISSECTION; TRANSECTION; ANGIOGRAPHY; RADIOGRAPHY; INJURY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
36
Recensione:
Indirizzi per estratti:
Citazione:
M.D. Smith et al., "TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE DIAGNOSIS OF TRAUMATIC RUPTURE OF THE AORTA", The New England journal of medicine, 332(6), 1995, pp. 356-362

Abstract

Background. Rupture of the aorta is a major cause of death after motor vehicle accidents. Survival depends on early diagnosis, and emergency aortography is the standard imaging method. Although transesophagealechocardiography is noninvasive and can provide high-resolution images of the aorta, information about its value in patients with trauma islimited. We conducted this study to assess prospectively the value oftransesophageal echocardiography in the emergency evaluation of patients at risk for aortic injury. Methods. Transesophageal echocardiography of the aorta was attempted in 101 patients admitted to the emergency room with a diagnosis of possible traumatic rupture of the aorta. Echocardiography and aortography personnel were notified simultaneously of the arrival of the patient, and the two tests were performed sequentially by operators who were blinded to the results of the other test. The sensitivity and specificity of transesophageal echocardiography were calculated on the basis of the results of aortography of the arch,surgery, or topsy. tempted in 101 patients. The study was successfully performed in 93 patients but could not be completed in 8 because of lack of cooperation on the part of the patient (7 patients) or maxillofacial trauma (1 patient). Despite a high injury-severity score (mean,29.6), transesophageal echocardiography was performed without complications, and within a mean (+/-SD) of 29+/-12 minutes. Eleven of the 93studies (12 percent) demonstrated rupture of the aorta near the isthmus. The findings were confirmed in 10 of the 11 patients by aortography (9 patients), surgery (9 patients), or autopsy (1 patient), yieldinga sensitivity of 100 percent and specificity of 98 percent for the detection of injury to the aorta. There was one false positive echocardiogram. Conclusions. Transesophageal echocardiography is a highly sensitive and specific method of detecting injury to the thoracic aorta. This technique can be used safely and quickly in critically injured patients with suspected traumatic rupture of the aorta and compares favorably with arch aortography.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 13:39:50