Diagnosis in the Early Phase of Aortic Dissection

  • S. Klugmann
  • A. Alberti
  • F. Faletra
  • A. Rampoldi
Conference paper


Aortic dissection is an emergency with an extremely high early mortality, time dependent (1–2% per hour) if not treated [1]. Survival however can be significantly improved by an appropriate therapy, medical or surgical. A prompt diagnosis therefore is mandatory in the treatment of this disease [2].


Aortic Dissection Transesophageal Echocardiography False Lumen Acute Aortic Dissection Intimal Flap 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hirst AE Jr, Johns VJ Jr, Kime SW Jr (1958) Dissecting aneurysm of aorta: a review of 505 cases. Medicine 37:217PubMedCrossRefGoogle Scholar
  2. 2.
    Daily PO, Trueblood HW, Stinson EB et al (1970) Management of acute aortic dissection. Ann Thorac Surg 10:237PubMedCrossRefGoogle Scholar
  3. 3.
    DeBakey ME, Mc Cullum CH, Crawford ES et al (1982) Dissection and dissecting aneurysms of the aorta: twenty year follow-up of five hundred twenty-seven patients treated surgically. Surgery 92:1118PubMedGoogle Scholar
  4. 4.
    Spittel PC, Spittel JA Jr, Joyce JW et al (1993) Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990). Mayo Clin Proc 68:642CrossRefGoogle Scholar
  5. 5.
    Isselbacher EM, Eagle KA, Desanctis RW (1997) Diseases of the aorta. In: Braunwald E (ed) Heart disease. A textbook of cardiovascular medicine. WB Saunders, Philadelphia, pp 1546–1581Google Scholar
  6. 6.
    Harris PD, Malm JR (1969) The management of acute aortic dissection of the thoracic aorta. Am Heart J 78:419–422PubMedCrossRefGoogle Scholar
  7. 7.
    Erbel R, Daniel W, Visser C et al and the European Cooperative Study Group for Echocardiography (1989) Echocardiography in diagnosis of aortic dissection. Lancet 1:457–461PubMedCrossRefGoogle Scholar
  8. 8.
    Cigarroa JE, Iselbacher EM, DeSanctis RW, Eagle KA (1993) Diagnostic imaging in the evaluation of suspected aortic dissection. N Engl J Med 328:35–43PubMedCrossRefGoogle Scholar
  9. 9.
    Nienaber CA, von Kodolitsch Y, Nicholas V et al (1993) The diagnosis of thoracic aortic dissection by non invasive imaging procedures. N Engl J Med 328:1–9PubMedCrossRefGoogle Scholar
  10. 10.
    Khanderia BK (1993) Aortic dissection, the last frontier. Circulation 87:1765–1768CrossRefGoogle Scholar
  11. 11.
    Erbel R, Mohr-Kahalay S, Rennollet H et al (1987) Diagnosis of aortic dissection: the value of transesophageal echocardiography. Thorac Cardiov Surg 2:126–133CrossRefGoogle Scholar
  12. 12.
    DeSanctis RW, Doroghazi RM, Austen WG, Buckley MJ (1987) Aortic dissection. N Engl J Med 317:1060–1067PubMedCrossRefGoogle Scholar
  13. 13.
    Nienaber CA, Spielman RP, von Kodolitsch Y et al (1992) Diagnosis of thoracic aortic dissection: Magnetic resonance imaging versus transesophageal echocardiography. Circulation 85:434–447PubMedCrossRefGoogle Scholar
  14. 14.
    Otto S, Pearlman AS (1995) Textbook of clinical echocardiography. WB Saunders, PhiladelphiaGoogle Scholar
  15. 15.
    Illiceto S, Nanda NC, Rizzon P et al (1987) Color Doppler evaluation of aortic dissection. Circulation 75:748–755CrossRefGoogle Scholar
  16. 16.
    Adachi H, Omoto R, Kyo S et al (1991) Emergency surgical intervention of acute aortic dissection with the rapid diagnosis by transesophageal echocardiography. Circulation 84;III: 14–19Google Scholar
  17. 17.
    Hashimoto S, Kumada T, Osakada G et al (1989) Assessment of transesophageal doppler echocardiography in dissecting aortic aneurysm. JACC 14:1253–1262PubMedCrossRefGoogle Scholar
  18. 18.
    Keren A, Kim CB, Hu BS et al (1996) Accuracy of biplane and multiplane transesophageal echocardiography in diagnosis of typical acute aortic dissection and intramural hematoma. JACC 28:627–636PubMedCrossRefGoogle Scholar
  19. 19.
    Goldman AP, Kotler MN, Scanlon MH et al (1986) The complementary role of magnetic resonance imaging, doppler echocardiography and computed tomography in the diagnosis of dissecting thoracic aneurysm. Am Heart J 111:970–981PubMedCrossRefGoogle Scholar
  20. 20.
    Victor MF, Mintz GS, Kotler MN et al (1981) Two dimensional echocardiography diagnosis of aortic aneurysm. Am J Cardiol 48:1155–1159PubMedCrossRefGoogle Scholar
  21. 21.
    Erbel R, Oelert H, Meyer J and The Cooperative Study Group on Echocardiography (1993) Effect of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography: implications for prognosis and therapy. Circulation 87:1604–1615PubMedCrossRefGoogle Scholar
  22. 22.
    Ballal RS, Nanda NC, Gatewood R et al (1991) Usefulness of transesophageal echocardiography in assessment of aortic dissection. Circulation 84:1903–1914PubMedCrossRefGoogle Scholar
  23. 23.
    Hayashi K, Maney TF, Zelch JV et al (1974) Aortographic analysis of aortic dissection. AJR Am J Roentgenol 122:769–782Google Scholar
  24. 24.
    Petasnik JR (1991) Radiologic evaluation of aortic dissection. Radiology 180:297–305Google Scholar
  25. 25.
    Pretre R, Segesser LK (1997) Aortic dissection. Lancet 343:1461–1464CrossRefGoogle Scholar
  26. 26.
    Earnest F IV, Muhm JR, Sheedy PF II (1979) Roentgenographic findings in thoracic aortic dissection. Mayo Clin Proc 54:43–50PubMedGoogle Scholar
  27. 27.
    Costello P, Damian E, Dupuy Dem Ecker CP, Tello RJ (1992) Spiral CT of thorax with reduced volume of contrast material: a comparative study. Radiology 183:663–666PubMedGoogle Scholar
  28. 28.
    Ney DR, Fishman EK, Niederhuber JE (1991) Threedimensional vascular imaging of the liver with spiral CT (abstract). Radiology 181:293Google Scholar
  29. 29.
    Erbel R, Oelert H, Meyer J et al (1991) Effect of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography. Circulation 894[Suppl iii]: 14–19Google Scholar

Copyright information

© Springer-Verlag Italia 1999

Authors and Affiliations

  • S. Klugmann
    • 1
  • A. Alberti
    • 1
  • F. Faletra
    • 1
  • A. Rampoldi
    • 1
  1. 1.Dept. of HaemodynamicsCa’Granda-Niguarda HospitalMilanItaly

Personalised recommendations