Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Mar 1998
Case ReportsPseudoaneurysm of the ascending aorta after aortic valve replacement.
A 58-year-old man with fever and chest wall tenderness was seen 8 weeks after aortic valve replacement. His initial postoperative course had been complicated by mediastinitis, requiring antibiotics and surgical debridement. ⋯ Pseudoaneurysm of the ascending aorta was suspected, based on computerized tomographic and magnetic resonance images of the chest. Intraoperative transesophageal echocardiography confirmed the diagnosis of pseudoaneurysm and was a key component in the patient's operative management.
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J Am Soc Echocardiogr · Feb 1998
Comparative StudyAccurate noninvasive estimation of left ventricular end-diastolic pressure: comparison with catheterization.
We evaluated the accuracy of a new Doppler-based method using the mitral regurgitant velocity at the time of aortic valve opening for the noninvasive estimation of left ventricular end-diastolic pressure. Sixty unselected patients were studied immediately before routine catheterization. Invasive left ventricular end-diastolic pressure was obtained using a fluid-filled pig-tail catheter. ⋯ In patients with a left ventricular end-diastolic pressure greater than 15 mm Hg the yield was 65%. Left ventricular end-diastolic pressures ranged from 4 mm Hg to 30 mm Hg. Bland and Altman analysis revealed no systematic bias and close agreement was found, with individual discrepancies not exceeding 5 mm Hg.
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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.