Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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Transesophageal echocardiography has been used as a diagnostic tool in the critical care unit. However, long-term serial evaluation of ventricular function with transesophageal echocardiography is difficult because of the current probe sizes and intolerance to prolonged oral intubation. We performed 139 intubations (64 oral and 75 transnasal) with a new prototype probe in 128 patients referred for transesophageal echocardiography. ⋯ Using custom developed software we showed the feasibility of monitoring left ventricular performance with minimal probe adjustment while graphically displaying and updating left ventricular area and fractional area change. Thus, transesophageal echocardiography with a prototype miniaturized monoplane probe passed transnasally is feasible, safe, and well tolerated by patients. This probe provides excellent two-dimensional echocardiographic images and may allow long-term echocardiographic monitoring of ventricular performance.
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J Am Soc Echocardiogr · Jul 1997
Normal echocardiographic characteristics of the Sorin Bicarbon bileaflet prosthetic heart valve in the mitral and aortic positions.
Doppler echocardiographic characteristics of normally functioning Sorin Bicarbon prostheses were prospectively assessed in 226 consecutive patients (135 male and 91 female patients, mean age 61 +/- 10 years) with 233 valves in the mitral (n = 67) and aortic (n = 166) positions whose function was considered normal by clinical and echocardiographic evaluation. Patterns of "normal" transprosthetic leakage were assessed with transthoracic echocardiography in all valves and with transesophageal echocardiography in six selected mitral valve prostheses. For the mitral valve prostheses, we found that peak and mean gradient, as well as pressure half-time, were not significantly different in either the 25 or the 31 mm valves (median values from 15 to 10 mm Hg, from 4 to 4 mm Hg, and from 70 to 83 ms; p = Not significant for all). ⋯ Furthermore, effective prosthetic aortic valve area correlated better than peak and mean gradients with prosthetic size (r = 0.76, r = -0.45, and r = -0.39, respectively). On transthoracic study, 109 patients (66%) showed minimal transprosthetic leakage. These normal values, obtained in a large number of patients with normofunctioning mitral and aortic Sorin Bicarbon valves, may help to identify Sorin Bicarbon prosthesis dysfunction.
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J Am Soc Echocardiogr · Jul 1997
Case ReportsTransesophageal echocardiography in the presence of left atrial calcification.
Calcification of left atrial walls is a rare finding that has been reported to hamper visibility of intracardiac structures during transesophageal echocardiography because of the posterior location of the left atrium. We report a case of severe mitral stenosis associated with heavy left atrial calcification in which we could obtain good quality transesophageal imaging in spite of such a calcification. We conclude that calcification of left atrial walls does not necessarily imply a limitation of transesophageal echocardiography.
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J Am Soc Echocardiogr · Jun 1997
Subaortic septal bulge simulates hypertrophic cardiomyopathy by angulation of the septum with age, independent of focal hypertrophy. An echocardiographic study.
Focal hypertrophy of the basal anterior septum occurs not infrequently in elderly patients and is considered by some to be a significant form of hypertrophic cardiomyopathy; others consider it to be an unimportant anatomic variant associated with an angulated septum, called a septal bulge (SB). We analyzed 94 cases of SB collected prospectively and compared them with 88 patients with extensive hypertrophic cardiomyopathy (HCM), 20 patients with hypertrophic cardiomyopathy limited to the entire septum (ASH), and 20 age-matched controls. The SB cases were also divided into three groups, with marked, moderate, or no basal septal hypertrophy associated with the occurrence of an SB. ⋯ It is concluded that outflow tract narrowing by an angulated septum is the primary mechanism responsible for the increased outflow tract velocity, rather than the hypertrophic septum. The resultant increase in convective acceleration simulates the dynamics of hypertrophic cardiomyopathy. The focal hypertrophy may be secondary and contributory to the enhanced ventricular dynamics, but it does not appear to be a primary cardiomyopathy.
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J Am Soc Echocardiogr · Jun 1997
Transesophageal echocardiography with the use of a four-millimeter probe.
Transesophageal echocardiography with the use of pediatric probes is nowadays commonly performed. However, in small children, insertion of a probe with a diameter of 7 mm may be traumatic or even impossible. ⋯ This probe was easy to insert, particularly during emergency situations, did not cause any complication in any patient, and provided satisfactory information despite the low number of elements. The use of a 4 mm transesophageal probe can improve the management of neonates with congenital heart disease in the operating room or the neonatal intensive care unit.