Transverse view of aortic rupture on TEE

This TEE transverse view demonstrates a traumatic subadventitial rupture of the aortic isthmus. There is a thick and highly mobile medial flap (arrow) associated with localized deformity of the anterolateral aortic wall (arrowheads) from acute formation of a false aneurysm. The flap is thicker compared with the intimal flap seen with aortic dissection since the entire depth of both the intima and media is involved with aortic rupture.