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Aortography involves placement of a catheter in the aorta and injection of contrast material while taking X-rays of the aorta. The procedure is known as an aortogram. The diagnosis of aortic dissection can be made by visualization of the intimal flap and flow of contrast material in both the true lumen and the false lumen.
Aortic aneurysms are often encountered during an X-ray, ultrasound, or echocardiogram done for other reasons. [3] IAA may also be found during a routine physical exam by feeling for bulges in the abdominal area. If an aortic aneurysm is suspected, medical history will be considered along with a physical examination.
A thoracic aortic aneurysm is an aortic aneurysm that presents primarily in the thorax. A thoracic aortic aneurysm is the "ballooning" of the upper aspect of the aorta, above the diaphragm. Untreated or unrecognized they can be fatal due to dissection or "popping" of the aneurysm leading to nearly instant death.
A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus. [1] This allows image and Doppler evaluation which can be recorded. It is commonly used during cardiac surgery and is an excellent modality for assessing the aorta, although there are some limitations. [2]
An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. [1] Typically, there are no symptoms except when the aneurysm dissects or ruptures , which causes sudden, severe pain in the abdomen and lower back.
The aorta normally has three small pouches that sit directly above the aortic valve (the sinuses of Valsalva), and an aneurysm of one of these sinuses is a thin-walled swelling. Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left (< 5%) coronary sinus. [ 1 ]
A typical use of ICE is for performing a transseptal puncture across the interatrial septum; in other words, pushing a catheter from the right atrium to the left atrium. Next to the septum is the aorta, and puncturing from the right atrium to the aorta is dangerous, and ICE visualization increases the confidence of performing this procedure safely.
The aortic wall dilatation at the commissural level causes the cusps to effectively shorten and prevent them from converging during systole, which results in aortic valve incompetence. The arch is typically spared from the aneurysmal process, though it may involve the entire ascending aorta. The ectatic aorta may experience dissections.