HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kazumasa Orihashi Yuichiro Matsuura Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Orihashi, K. Articles by Ishii, O. Search for Related Content PubMed PubMed Citation Articles by Orihashi, K. Articles by Ishii, O.

J Thorac Cardiovasc Surg 2000;120:466-472
© 2000 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Aortic arch branches are no longer a blind zone for transesophageal echocardiography: A new eye for aortic surgeons

From the First Department of Surgery, Hiroshima University School of Medicine, Hiroshima, Japan.

Address for reprints: Kazumasa Orihashi, MD, First Department of Surgery, Hiroshima University School of Medicine, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551 Japan (E-mail: ka-ori{at}mcai.med.hiroshima-u.ac.jp ).

Objectives: Branch arteries of the aortic arch have been a blind zone for transesophageal echocardiography. Information regarding blood flow, which is important in both planned and emergency operations on the aorta, has therefore been limited. We have established a technique for visualizing these arteries in nearly all cases.
Methods: In 25 consecutive patients requiring either planned or emergency operations on the aorta, the branch arteries were visualized whenever cerebral malperfusion was suspected. Lateral flexion of the probe tip was used when the trachea interfered with visualization of the arteries.
Results: The left subclavian, left and right common carotid, right subclavian, innominate, and left and right vertebral arteries were visualized in 96% (24/25), 92% (23/25), 96% (24/25), 100% (25/25), 84% (21/25), 92% (22/24), and 88% (21/24), respectively. The origin of the innominate artery was visualized in 36% (9/25). In some cases, dissection extended into branch arteries during surgery or during conservative therapy. When the subclavian artery was clamped, retrograde flow was detected in the vertebral artery (steal flow). The cannula for selective cerebral perfusion occasionally was entered into the right common carotid or subclavian artery and obstructed the other branch with a balloon.
Conclusions: The branch arteries of the aortic arch, including the vertebral artery, are no longer a blind zone for transesophageal echocardiography. The information obtained with our new transesophageal echocardiography technique is helpful for diagnosis, monitoring, and decision making during aortic surgery and in critical care medicine. Visualizing these vessels is worth the effort.

This article has been cited by other articles:

				Y.-L. Li, D. T. Wong, W. Wei, and J. Liu A novel acoustic window for trans-oesophageal echocardiography by using a saline-filled endotracheal balloon Br. J. Anaesth., November 1, 2006; 97(5): 624 - 629. [Abstract] [Full Text] [PDF]

				K. Orihashi, T. Sueda, K. Okada, and K. Imai Malposition of selective cerebral perfusion catheter is not a rare event Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 644 - 648. [Abstract] [Full Text] [PDF]

				K. Orihashi, T. Sueda, K. Okada, and K. Imai Left Internal Thoracic Artery Graft Assessed by Means of Intraoperative Transesophageal Echocardiography Ann. Thorac. Surg., February 1, 2005; 79(2): 580 - 584. [Abstract] [Full Text] [PDF]

				K. Orihashi, T. Sueda, M. Watari, K. Okada, O. Ishii, and Y. Matsuura Endovascular stent-grafting via the aortic arch for distal aortic arch aneurysm: an alternative to endovascular stent-grafting Eur. J. Cardiothorac. Surg., November 1, 2001; 20(5): 973 - 978. [Abstract] [Full Text] [PDF]