Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Sep 1996
Case ReportsMycotic aneurysm of the descending thoracic aorta: the role of transesophageal echocardiography.
Mycotic aneurysms of the aorta are prone to rupture. Thus rapid and accurate diagnosis is essential so that surgical repair can be undertaken. ⋯ Computed tomography and aortography were complementary to transesophageal echocardiography in establishing the diagnosis. The patient underwent successful repair and acute inflammation of the aneurysm was present at histologic examination.
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J Am Soc Echocardiogr · Sep 1996
Bioprosthetic mitral valve thrombosis: clinical profile, transesophageal echocardiographic features, and follow-up after anticoagulant therapy.
Cardiac bioprosthetic valve thrombosis is frequently found on pathologic examination, but preoperative diagnosis is rarely performed. Four hundred six patients with mitral porcine xenograft bioprostheses were examined by transthoracic echocardiography. Transesophageal echocardiography (TEE) was performed in 161 of the patients, with clinical or echocardiographic criteria of prosthetic malfunction. ⋯ Mitral valve prosthetic mean gradient decreased from 11.8 +/- 4.5 to 7.6 +/- 3.7 mm Hg (p < 0.001), and mitral valve area increased from 1.13 +/- 0.3 to 1.72 +/- 0.6 cm2 (p < 0.001). Long-term symptomatic improvement after anticoagulation was obtained in seven patients. Thus this study shows that mitral bioprosthetic thrombosis is a relatively frequent cause of valve dysfunction, TEE is useful for detecting thrombus in relation to mitral bioprosthetic valves, and oral anticoagulation is effective in resolving thrombosis on bioprostheses.
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J Am Soc Echocardiogr · Sep 1996
Spectrum of acute dissection of the ascending aorta: a transesophageal echocardiographic study.
Transesophageal echocardiography is an accurate tool for the immediate diagnosis of acute aortic dissection. In addition to establishing the diagnosis of dissection, transesophageal echocardiography provides determination of its extent and detection of complications. The purpose of this study was to delineate the full spectrum of abnormalities present in acute dissection of the ascending aorta as assessed by transesophageal echocardiography. ⋯ We conclude that acute dissection of the ascending aorta results in a complex or convoluted flap rather than a simple linear tear in many patients. The complication of clinically significant pericardial effusion was rare. Aortic insufficiency is common and can be attributed to multiple mechanisms.
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J Am Soc Echocardiogr · Jul 1996
Clinical TrialDobutamine stress ultrasonic myocardial tissue characterization in patients with dilated cardiomyopathy.
Although acoustic properties of the myocardium are different between patients with cardiomyopathy and normal subjects, the frequency of the abnormal properties in patients with cardiomyopathy is unknown. We assessed the frequency of abnormal acoustic properties of the myocardium detectable with integrated backscatter in patients with cardiomyopathy and attempted more sensitive ultrasonic tissue characterization by combining dobutamine stress testing in patients with cardiomyopathy with apparently normal acoustic properties of the myocardium at rest. The magnitude of cyclic variation of integrated backscatter and calibrated myocardial integrated backscatter at end diastole were measured in 36 normal subjects and 40 patients with dilated cardiomyopathy. ⋯ Abnormal acoustic properties are detectable at rest with myocardial integrated backscatter about in three quarters of patients with cardiomyopathy. A combination of dobutamine stress testing would provide more sensitive ultrasonic myocardial tissue characterization and may make it possible to detect subtle changes in the acoustic properties of the myocardium in patients with dilated cardiomyopathy. Therefore dobutamine stress ultrasonic tissue characterization may detect mild dilated cardiomyopathy.
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J Am Soc Echocardiogr · May 1996
How positionally stable is a transesophageal echocardiographic probe? Implications for three-dimensional reconstruction.
Three-dimensional (3D) reconstruction from a single esophageal scanning position requires a stable relationship between the probe and the heart. The purpose of this study was to examine the movement of a transesophageal echocardiographic probe during 3D image acquisition. A new dual-axis multiplane probe was used that includes a miniature (6 x 6 x 9 mm) magnetic sensor in the tip. ⋯ Translational movement was more dominant than was rotational movement. Misregistration of three-dimensional reconstructions may be due to subtle probe movement. The ability to monitor probe movement may be helpful in optimizing 3D data sets.