Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Sep 1995
Case ReportsCoronary artery compression caused by a large pseudoaneurysm of the mitral-aortic intervalvular fibrosa.
An unusual late complication of bacterial endocarditis is described. Four years after diagnosis and treatment, a patient is seen with coronary artery compression caused by a large pseudoaneurysm of the mitral-aortic intervalvular fibrosa. The utility of transesophageal echocardiography in diagnosis and surgical management is emphasized.
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Recent studies have suggested that intermediate-frequency M-Mode transthoracic echocardiographic imaging is a promising method for evaluating the left ventricle in transgenic mice. However, there is a paucity of data regarding two-dimensional (2-D) echocardiography and cardiac Doppler echocardiography in this model. Therefore we studied 15 mice (body weights 38 to 65 gm) with an ultrasound system equipped with a 9 MHz transducer. ⋯ In this study left ventricular mass was assessed better by 2-D measurement of left ventricular dimensions. Assessment of left ventricular performance is feasible. Color Doppler-guided evaluation of aortic flow and aortic root measurement permits assessment of stroke volume and cardiac output.
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J Am Soc Echocardiogr · Jul 1995
Comparative Study Clinical TrialNew miniaturized versus conventional biplane transesophageal transducers: recent clinical experience in adults.
A subset of patients have substantial discomfort on examination with transesophageal echocardiography with the conventional probe, whereby the dimensions of the probe play a decisive role. Miniaturized biplane transducers have recently become available (2 x 32 channels, dimensions 9.5 x 8.7 mm, and circumference approximately 30% less than the conventional echoscope) and allow ultrasound examination at 3.5, 5.0 and 7.0 MHz. A prospective study was carried out in 90 patients to compare difficulties on insertion of the probe, subjective evaluation by the patient during examination, and the two-dimensional image, as well as Doppler and color-coded Doppler quality of the miniaturized biplane versus the conventional probe. ⋯ With transmit/receive frequency of 7.0 MHz, however, image resolution was excellent in the near field of 5 cm and nearly equivalent to that of the conventional probe (5.0 MHz). Pulsed-wave and continuous wave Doppler and color-coded Doppler information from both probes was similar in quality. Whenever examination with a conventional transesophageal transducer promises to be difficult, or when sedation is contraindicated because of a severe illness or respiratory insufficiency, transesophageal echocardiography should be considered with a smaller biplane probe at higher transmit-receive frequencies.
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J Am Soc Echocardiogr · May 1995
Transesophageal transgastric echocardiography in infants and children: the subcostal view equivalent.
Transesophageal echocardiography has been limited in the assessment of congenital heart disease involving ventriculoarterial connections. These can be viewed with biplane imaging, but the angle of incidence does not permit assessment of gradients. To determine whether transgastric transesophageal imaging could provide this information, we examined 127 infants and children during cardiac surgery, ranging from 2.7 to 32 kg in weight and 1 day to 16 years in age. ⋯ Doppler estimates of pressure drops across the ventricular outflow tracts were within good limits of agreement with estimates obtained by manometry. There were no major complications from this technique. We conclude that the transgastric viewing plane enhances the usefulness of intraoperative transesophageal echocardiography for diagnosis and evaluation of congenital heart lesions by permitting more complete echocardiographic examinations and detection of areas of residual obstruction across the ventricular outflow tracts.
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J Am Soc Echocardiogr · Mar 1995
Case ReportsContinuous monitoring by biplane transesophageal echocardiography of pulmonary and paradoxical embolism.
Paradoxical embolism is considered a relatively uncommon disease. Continuous biplane transesophageal echocardiography (TEE) was performed in a 64-year-old woman who had an acute pulmonary embolism. TEE showed an elongated formation highly mobile within both atria. ⋯ Systemic embolism of the right arm was noted. The patient died 5 hours after admission, and postmortem examination confirmed the diagnosis of pulmonary embolism. This case demonstrates the potential utility of TEE in the study of patients with suspected paradoxical embolism.