{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:28:10Z","timestamp":1787772490257,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Thoracic endovascular aortic repair (TEVAR) plays a central role in managing acute and chronic aortic pathologies. With the advancement of transcatheter structural heart procedures, echocardiography has become a key in procedural guidance. Despite consensus on its use for cardiac interventions, ultrasound assistance in aortic procedures is not widely standardized. A 71-year-old obese man with chronic type B aortic dissection underwent a TEVAR procedure, using a single-branched aortic stent graft (Endovastec\u2122 Castor\u2122) and with transesophageal ultrasound guidance. The preprocedural assessment confirmed the presence of aortic dissection of the descending thoracic aorta with a posterior true lumen (TL) and an anterior false lumen (FL), normal aortic valve anatomy and function, normal left ventricular function, absence of intracavity thrombus, and absence of aortic plaques that could prevent the optimal implantation of the stent graft. During the procedure, a transesophageal echocardiogram (TEE) monitored the positioning of the guide wires, the arrival of the catheter of the thoracic endoprosthesis, and then the implantation of this at the level of the aortic arch and the descending thoracic aorta. Postprocedure TEE evaluation underlined full stent-graft deployment without leaks and successful exclusion of FL with the beginning of thrombosis. Angiography confirms the exclusion of the aneurysm and the absence of endoleaks. This clinical case demonstrates how transesophageal echocardiographic guidance can improve the TEVAR procedure by minimizing fluoroscopy time, contrast medium use, and enabling a better assessment of the dissection anatomy with real-time monitoring of both the TL and the FL. In conclusion, TEE can serve as an auxiliary intraoperative imaging tool to provide good information before, during, and after the procedure, increasing the success and safety of the TEVAR.<\/jats:p>","DOI":"10.4103\/jcecho.jcecho_64_23","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T04:32:52Z","timestamp":1717389172000},"page":"148-152","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["A Case of Type B Aortic Dissection: The Role of Transesophageal Ultrasound Guidance in Thoracic Endovascular Aortic Repair"],"prefix":"10.4103","volume":"33","author":[{"given":"Giancarlo","family":"Trimarchi","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Benedetti","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiac Surgery, Fondazione Toscana G. Monasterio, Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cataldo","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiac Surgery, Fondazione Toscana G. Monasterio, Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Rizza","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiac Surgery, Fondazione Toscana G. Monasterio, Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"R1-20240904","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1093\/ejcts\/ezaa268","article-title":"Current options and recommendations for the use of thoracic endovascular aortic repair in acute and chronic thoracic aortic disease:An expert consensus document of the European Society for Cardiology (ESC) working group of cardiovascular surgery, the ESC working group on aorta and peripheral vascular diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"59","author":"Czerny","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"R2-20240904","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1161\/CIR.0000000000001106","article-title":"2022 ACC\/AHA guideline for the diagnosis and management of aortic disease:A report of the American Heart Association\/American College of Cardiology Joint Committee on clinical practice guidelines","volume":"146","author":"Isselbacher","year":"2022","journal-title":"Circulation"},{"key":"R3-20240904","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.pcad.2018.11.009","article-title":"Echocardiography in transcatheter structural heart disease interventions","volume":"61","author":"Patel","year":"2018","journal-title":"Prog Cardiovasc Dis"},{"key":"R4-20240904","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1055\/s-0042-1743107","article-title":"Transesophageal ultrasound guidance for endovascular interventions on the aorta","volume":"10","author":"Castro-Verdes","year":"2022","journal-title":"Aorta (Stamford)"},{"key":"R5-20240904","doi-asserted-by":"crossref","first-page":"995173","DOI":"10.3389\/fcvm.2022.995173","article-title":"Single-center experience with a unibody single-branched stent graft for zone 2 thoracic endovascular aortic repair","volume":"9","author":"Kong","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"R6-20240904","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1093\/eurheartj\/ehs074","article-title":"Thoracic Endovascular Aortic Repair (TEVAR) for the treatment of aortic diseases:A position statement from the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)","volume":"33","author":"Grabenw\u00f6ger","year":"2012","journal-title":"Eur Heart J"},{"key":"R7-20240904","doi-asserted-by":"crossref","first-page":"S138","DOI":"10.21037\/cdt.2017.09.17","article-title":"Complications of endovascular aneurysm repair of the thoracic and abdominal aorta:Evaluation and management","volume":"8","author":"Daye","year":"2018","journal-title":"Cardiovasc Diagn 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echocardiography during stent grafting for aortic dissection:A report of three cases","volume":"11","author":"Hirose","year":"2018","journal-title":"Ann Vasc Dis"}],"container-title":["Journal of Cardiovascular 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