Aortic Arch

The aortic arch is usually seen in its long axis as the probe is gently withdrawn from the pulmonary artery bifurcation to about 18-20 cm from the incisors and slowly rotating the probe to the left. Cross sections of the aortic arch including the origin of the neck vessels can be obtained in the majority of patients by careful manipulation of the probe tip controls and incremental imaging from 0 to 45, 60, and 90 degrees. Care needs to be taken at this level

Figure 4.11A. Demonstrates the mechanism of aortic regurgitation in a type A aortic dissection. Note that intimai flap prolapse into the LVOT interferes with the coaptation of the aortic cusps leading to regurgitation. Reprinted from J. Invasive Cardiol. 1 (1989), 328-338 with permission from HMP Communications.

Figure 4.11A. Demonstrates the mechanism of aortic regurgitation in a type A aortic dissection. Note that intimai flap prolapse into the LVOT interferes with the coaptation of the aortic cusps leading to regurgitation. Reprinted from J. Invasive Cardiol. 1 (1989), 328-338 with permission from HMP Communications.

Figure 4.11B. Demonstrates a localized dissection of the posterior aortic root in a patient with aortic valve replacement. Reprinted from J. Invasive Cardiol. 1 (1989), 328-338 with permission from HMP Communications.

since the probe tip is in the very proximal esophagus and can be easily pulled out accidentally. In addition, it is important to realize that excessive probe manipulation at this level can result in pain and discomfort for the patient.

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