Cardiology
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In a 79-year-old female with shortness of breath, catheterization via the femoral vein encountered difficulty entering the right heart; venography revealed anomalous drainage of the inferior vena cava via a dilated azygos vein permitting subsequent catheterization. Similar difficulties during catheterization merit consideration of this congenital anomaly, which is virtually always discovered in the pediatric population in association with other congenital anomalies. Its unique discovery at advanced age indicates its benignity as an isolated abnormality.
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Case Reports
Transesophageal echocardiography as an important tool in the diagnosis of postinfarction papillary muscle rupture.
Papillary muscle complicating acute myocardial infarction is an uncommon but potentially catastrophic event. We present 3 such cases to illustrate the difficulties in early identification of rupture. In each case, transesophageal echocardiography was employed providing rapid and unequivocal identification of the disorder. Prompt surgical intervention led to survival in 2 patients.
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The aim of this study was to assess the performance of pediatric-size oximetry catheters in diagnostic heart catheterization. Measurements of pressures and oxygen saturations were obtained with oximetry catheters as well as with standard methods during routine heart catheterizations in 10 infants and children with congenital heart defects. ⋯ Oxygen saturation measurements exhibited bias and scatter. It is concluded that no advantage is obtained by the use of oximetry catheters in diagnostic heart catheterization in children and infants.
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Clinical Trial Controlled Clinical Trial
Left atrial appendage function determined by transesophageal echocardiography in patients with rheumatic mitral valve disease.
Left atrial thrombi have been considered to be the major source of systemic arterial embolization in patients with rheumatic mitral valve disease. Almost half of the left atrial thrombi are found in the left atrial appendage (LAA). To investigate LAA size and LAA contractile function in patients with rheumatic mitral valve disease, transesophageal echocardiographic and Doppler studies were performed in 61 patients. ⋯ LAA ejection fraction and LAA peak emptying velocity were lower in this group, too. A higher incidence of LAA SEC formation was found in these patients with rheumatic mitral valve disease (4/15 vs. 0/22; p = 0.021). There was no significant difference, however, in LAA thrombus formation between group 2 and its control group (1/15 vs. 1/22; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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Electrophysiological studies were performed in 26 patients with atrial fibrillation (AF). Thirteen patients had the Wolff-Parkinson-White (WPW) syndrome (group A), and another 13 patients did not have the WPW syndrome (group B). ⋯ The wavelength index which was defined as the ratio of the refractory period to the conduction delay was significantly lower in group A than in group B. Accordingly, patients in group A had a greater tendency to produce atrial reentry than those in group B.