1. Although multiple modalities may be used for evaluation of the aortic root, cardiac CT is the gold standard for all pathology of the aorta, including the exclusion and characterization of type A dissection. Parasternal long-axis image from trans-thoracic echocardiogram (A) demonstrates a linear area of echogenicity (white arrow) above the noncoronary cusp of the aortic valve concerning for an intimal flap. The finding was detected incidentally in a patient with recent stroke and possible PFO. Subsequent trans-esophageal echocardiogram (B) again demonstrated the finding. Axial image from cardiac CT scan (C) provides excellent visualization of the aortic root and definitively excludes the present of an intimal flap. Sagittal oblique maximum intensity projection image (D) demonstrates aortic root and ascending aorta to be normal. No further evaluation is needed. Echocardiographic findings were presumed to be from artifact.
Source: Computed Tomography of the Adult Cardiac Surgery Patient: Principles and Applications, Cardiac Surgery in the Adult, 5e
Citation: Cohn LH, Adams DH. Cardiac Surgery in the Adult, 5e; 2017 Available at: Accessed: October 18, 2017
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