Get access

Transesophageal Echocardiography of the Descending Thoracic Aorta: Establishing an Accurate Anatomic Marker Using the Celiac Artery

Authors

  • Samip Vasaiwala M.D.,

    1. Brigham and Women's Hospital, Boston, Massachusetts
    Search for more papers by this author
  • Mladen I. Vidovich M.D., F.A.C.C.,

    1. Department of Medicine, Section of Cardiology, University of Illinois at Chicago College of Medicine, Chicago, Illinois
    2. Jesse Brown Veterans Administration Hospital, Chicago, Illinois
    Search for more papers by this author
  • John Connolly M.D.,

    1. Resurrection Health Care, Chicago, Illinois
    Search for more papers by this author
  • Leon Frazin M.D., F.A.C.C.

    1. Department of Medicine, Section of Cardiology, University of Illinois at Chicago College of Medicine, Chicago, Illinois
    2. Jesse Brown Veterans Administration Hospital, Chicago, Illinois
    3. Resurrection Health Care, Chicago, Illinois
    Search for more papers by this author

  • Grant support: none.

  • Conflict of interest: none.

Address for correspondence and reprint requests: Leon Frazin, M.D., F.A.C.C., Cardiovascular Division, University of Illinois at Chicago, 840 South Wood Street, MC 715, Chicago, IL 60610. Fax: 312-569-8019; E-mail: lfrazin@aol.com

Abstract

Objective: We performed transesophageal echocardiography (TEE) and computed tomography (CT) on patients with aortic pathology to describe a more anatomically coherent marker on TEE studies by using the celiac artery as a reference. Background: As there are no anatomic markers for the eight-vertebrae long descending thoracic aorta, aortic disease (AD) is routinely reported as a distance from the dental incisors in TEE studies. This method does not provide an anatomically accurate location of AD relative to recognizable anatomy. Methods: Ten patients referred for contrast CT and TEE for evaluation of embolic events were studied. Twenty-seven focal aortic lesions found on TEE were measured relative to their distance from the celiac artery. The agreement among the two methods of quantification of aortic lesions from the celiac artery was assessed by univariate regression analysis and by the Bland–Altman method. Difference in the mean values between the two groups was analyzed by paired t-test. Results: The P value for the two-tailed t-test for the difference between the two modalities was 0.122. The Pearson coefficient for comparison of CT and TEE data was 0.98. The coefficient of determination for TEE versus CT data was 0.96. Conclusions: The TEE CA reference marker proves to be an accurate method for localizing disease in the descending thoracic aorta relative to CT findings. Reporting of aortic disease relative to this marker is more clinically applicable than the current method of measurement. The CA reference marker should be routinely reported in TEE studies to enhance the diagnosis of aortic disease. (Echocardiography 2010;27:1093-1097)

Ancillary