Tortuous Descending Thoracic Aorta in a Patient with a History of Ascending Aorta Replacement as a Confounder in Transesophageal Echocardiographic Evaluation of the Left Atrium: A Procedural Challenge

Sahar  Asl-Fallah; Ali  Hosseinsabet; Shapoor  Shirani; Alimohammad  Hajizeinali

doi:10.18502/jthc.v21i2.21697

Sahar Asl-Fallah Cardiology Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Ali Hosseinsabet Cardiology Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Shapoor Shirani Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Alimohammad Hajizeinali Cardiology Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v21i2.21697

Keywords: Echocardiography; Mediastinal Mass; Descending Aorta; Aortic Tortuosity

Abstract

Descending thoracic aorta tortuosity results from elongation of the descending aorta and is associated with aging. It acts as a risk factor for challenging endovascular procedures and has prognostic significance. It may, however, sometimes present as a vascular mass in the mediastinum, distorting nearby cardiac chambers, which may confuse physicians during transesophageal echocardiography.

We describe an elderly woman with severe descending thoracic aorta tortuosity presenting with a tubular vascular mass located behind the left atrium, exerting compression on it. Recognizing the potential echocardiographic presentation of aortic tortuosity can aid in the timely identification of this condition during transesophageal echocardiography.