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Transesophageal echocardiography in the detection of cardiovascular sources of peripheral vascular embolism

  • Original Articles
  • Published:
Annals of Vascular Surgery

Abstract

The purpose of this study was to determine the impact of transesophageal echocardiography (TEE) on the management of patients with peripheral vascular emboli. We prospectively evaluated the role of TEE in 15 patients with documented peripheral emboli and no evidence of occlusive peripheral vascular disease. The patients were divided in two groups for analysis: group 1 (n=8) had no clinical evidence of heart disease and group 2 (n=7) had clinically significant heart disease. TEE provided information regarding the source of embolism in four (50%) patients in group 1, and these findings significantly affected the management of all. Three patients underwent thoracic surgery to remove the source of embolism (aortic valve mass in one and a thrombus in the descending thoracic aorta in two); the other patient was treated with thrombolytic agents. TEE findings had high diagnostic value in all patients in group 2, but the results had a possible effect on clinical management in only two of these patients. TEE provides diagnostic information in most patients with peripheral vascular emboli and this information has a significant influence on management, particularly in those without clinically evident heart disease. TEE should be performed in all patients with documented peripheral embolism.

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Author information

Authors and Affiliations

  1. Division of Cardiology, Washington University School of Medicine, St. Louis, Mo.

    Víctor G. Dávila-Román MD, Donald Westerhausen MD, William E. Hopkins MD & Benico Barzilai MD

  2. Division of Vascular Surgery, Washington University School of Medicine, St. Louis, Mo.

    Gregorio A. Sicard MD

Authors
  1. Víctor G. Dávila-Román MD
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  2. Donald Westerhausen MD
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  3. William E. Hopkins MD
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  4. Gregorio A. Sicard MD
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  5. Benico Barzilai MD
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Additional information

Supported in part by a Minority Investigator Research Supplement (MIRS) to the Specialized Center of Research in Coronary and Vascular Diseases Grant (HL 17646), National Institutes of Health, Bethesda, Md., and by an American Heart Association Minority Scientist Development Award (both awarded to Dr. Dávila-Román).

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Dávila-Román, V.G., Westerhausen, D., Hopkins, W.E. et al. Transesophageal echocardiography in the detection of cardiovascular sources of peripheral vascular embolism. Annals of Vascular Surgery 9, 252–260 (1995). https://doi.org/10.1007/BF02135284

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