112: A new morphological and quantitative approach of aortic atheroma: a preliminary 3D transesophageal echocardiography study

Aortic atheroma is a disease causing vascular complications including ischemic stroke. Transesophageal echocardiography (TEE) is the diagnostic method of reference for characterization of aortic atherosclerotic plaques (AAP) at risk. Objective The aim of our study was to evaluate the feasibility and contribution of 3D TEE in the evaluation of aortic atheroma. Methods and results We prospectively included 82 patients referred for TEE. In addition to conventional 2D TEE, a 3D TEE study of AAP of the descending and horizontal thoracic aorta was performed. Overall, 308 AAP were identified in 2D, 98% of them were analyzed using the 3D approach. We identified 3 morphological types of plaques using the 3D approach (figure 1), 2D characteristics of the 3D types of AAP were different. Type I AAP are thin and rarely calcified; type III AAP are thicker and often calcified; the 3D type II AAP have intermediate 2D characteristics (Table). All AAP ulcerations seen in 2D were identified in 3D TEE. 2D thickness measurements from 3D acquisitions correlated well with measurements performed directly on the 2D acquisitions (r=0.91; p Conclusion 3D TEE is a feasible method for the analysis of the AAP. It provides a new morphological and quantitative approach of AAP whose clinical applications remain to be validated. Download full-size image Figure – 3D morphological types of plaques Table . Results Type I (n=115) Type II (n=97) Type III (n=89) N Descending Aorta (n) 77 63 49 189 Horizontal Aorta (n) 38 34 40 112 Plaque thickness (mean ± SD; mm) 1.2±0.5 2.6±1.2 3.2±1.5 Not calcified plaques (n,%) 103 (80.5) 22 (17.2) 3 (2.3) 128 Slightly calcified plaques (n,%) 9 (8.8) 62 (60.8) 31(30.4) 102 Very calcified plaques (n,%) 3 (4.2) 13 (18.3) 55 (77.5) 71