Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Jan 1998
Case ReportsRetained left atrial catheter: an unusual cardiac source of embolism identified by transesophageal echocardiography.
Embolic events have become a major indication for transesophageal echocardiography. We report three patients with cerebrovascular accident who were discovered to have retained left atrial catheter as a cardiac source of embolism. These radiolucent catheters, placed during previous cardiac surgery, were used for perioperative left atrial monitoring. ⋯ All patients underwent reoperation to remove the retained catheter and have had no recurrent embolic events. Although uncommon, retained catheter in the left atrium is an important potential source of systemic embolism. The diagnosis can be easily made with transesophageal echocardiography and should prompt surgical extraction of the catheter.
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J Am Soc Echocardiogr · Jan 1998
Diagnostic accuracy and role of intraoperative biplane transesophageal echocardiography in pediatric patients with left ventricle outflow tract lesions.
To define the lesion-specific role of biplane transesophageal echocardiography in children with left ventricular outflow tract obstructive lesions, the diagnostic accuracy of transthoracic and transesophageal images were compared, and the impact of transesophageal echocardiography on perioperative management was evaluated. ⋯ Transesophageal echocardiography can be a reliable diagnostic tool and has an important role in the surgical management of left ventricular outflow tract lesions in children.
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J Am Soc Echocardiogr · Jan 1998
Case ReportsComplete morphologic and functional resolution of endocarditis of a Toronto stentless porcine bioprosthesis: a study by serial transesophageal echocardiography.
Prosthetic valve endocarditis is a serious complication after valve replacement with an incidence of 0.8% for both mechanical and bioprosthetic valves. The new Toronto stentless porcine valve (SPV) for aortic replacement offers promising early results in hemodynamics and a low incidence of valve-related complications. ⋯ This is the case of a patient with late prosthetic valve endocarditis of a Toronto SPV bioprosthesis, who, in spite of large vegetations on all three valve cusps, responded well to conservative treatment. This response was monitored through repeated transesophageal echocardiographic studies (TEE), which documented complete functional recovery of the valve.
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J Am Soc Echocardiogr · Jan 1998
Case ReportsHypertrophic cardiomyopathy with obstruction: important diagnostic clue provided by the direction of the mitral regurgitation jet.
We present an unusual case of hypertrophic cardiomyopathy complicated by mitral regurgitation resulting from chordal rupture with flail posterior mitral leaflet. The diagnosis was suggested by the presence of an anteriorly directed mitral regurgitation jet on transthoracic color flow imaging, in addition to the typical posterolateral-lateral jet caused by systolic anterior mitral motion. ⋯ This combination of hypertrophic cardiomyopathy and flail mitral leaflet usually requires surgical intervention, and prompt diagnosis is important. The presence of an anteriorly directed mitral regurgitant jet should always raise suspicion of posterior mitral leaflet abnormality.
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J Am Soc Echocardiogr · Jan 1998
Lack of lung hemorrhage in humans after intraoperative transesophageal echocardiography with ultrasound exposure conditions similar to those causing lung hemorrhage in laboratory animals.
This study investigated the phenomenon of ultrasonically induced lung hemorrhage in humans. Multiple experimental laboratories have shown that diagnostic ultrasound exposure can cause hemorrhage in the lungs of laboratory animals. The left lung of 50 patients (6 women, 44 men, mean age 61 years) was observed directly by the surgeon after routine intraoperative transesophageal echocardiography was performed. ⋯ No hemorrhage was noted on any lung surface by the surgeon on gross observation. We conclude that clinical transesophageal echocardiography, even at field levels a little greater than the reported thresholds for lung hemorrhage in laboratory animals, did not cause surface lung hemorrhage apparent on gross observation. These negative results support the conclusion that the human lung is not markedly more sensitive to ultrasound exposure than that of other mammals.