Texas Heart Institute journal
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Case Reports
Transesophageal electrocardiography and adenosine in the diagnosis of wide complex tachycardia.
The diagnosis of wide complex tachycardia based on surface electrocardiography can be difficult. Misdiagnosis occurs frequently and is commonly associated with increased morbidity and mortality. We describe a case of wide QRS complex tachycardia in which transesophageal electrocardiography and intravenous adenosine were used to obtain a reliable diagnosis. These are safe and readily available tools for elucidating the mechanism of wide complex tachyarrhythmias in hemodynamically stable patients.
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Since 1988, reparative techniques have been used at our institution to treat valvular insufficiency in selected patients with aortic valve disease. The limitations of aortic valve replacement are well recognized; it is this knowledge that has motivated us to find out whether a subgroup of patients who have aortic insufficiency might be candidates for preservation of their native aortic valves. This subgroup includes patients who have leaflet prolapse, perforation, or calcification. We describe our methods of patient evaluation and selection, as well as our surgical techniques for both bicuspid and tricuspid aortic valve repair.