Herz
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Monoplane transesophageal echocardiography (TEE) is a well established diagnostic tool of examination of great value in determining pathological changes in both atria, atrioventricular valves, the left-ventricular outflow tract, and in the thoracic aorta (Table 1). With the monoplane technique, however, it is never possible to obtain more than parallel, or oblique transverse views of the heart and surrounding vessels. The only means with which to examine anatomic structures in their cranio-caudal dimension by way of this method is to make a composite of a number of transverse sections. ⋯ By using the longitudinal imaging plane left atrial appendage can be seen without additional anteflection of the probe, thus, reducing stress to the patient during examination. The loss of an infinite range of planes available to the multiplane technique is a disadvantage, but this can usually be compensated by appropriate flecting of the probe and adequate simultaneous lateral angulation. The range of rotation of the probe in the multiplane method allows better three-dimensional imaging of anatomic structures and regurgitant jets than do the mono- and biplane techniques, and comparable data are often only attained under much longer examination with the biplane instrument.(ABSTRACT TRUNCATED AT 400 WORDS)
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The percentage of ischemic strokes or peripheral arterial embolism attributed to cardiogenic embolism is about 30% and 75%, respectively. Diagnostic work-up in patients with prior arterial embolism is of prognostic importance, because embolic events are often recurrent. Cardioembolic sources with major risk of embolism are atrial fibrillation, mechanical or biological heart valve prosthesis, left ventricular or left atrial thrombi, left atrial myxomas, bacterial endocarditis, nonbacterial thrombotic endocarditis and nonischemic dilative cardiomyopathies. ⋯ Only left ventricular thrombi could be better evaluated by the transthoracic method, because visualization of the left ventricular apex by the transesophageal approach is problematic. In patients with systemic arterial embolism the combination of transthoracic and transesophageal echocardiography is the diagnostic method of choice to detect a cardioembolic source. Randomized studies in the future must prove, whether the echocardiographic findings can lead to better therapeutic strategies to improve the prognosis of patients with embolic disease.