Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Sep 1994
A prospective study of left atrial spontaneous echo contrast and thrombus in 100 consecutive patients referred for balloon dilation of the mitral valve.
The aim of this study was to determine the clinical, echocardiographic, and hemodynamic predictors of left atrial spontaneous echo contrast (SEC) and thrombus, respectively, in patients referred for balloon dilation of the mitral valve and to establish the relationship between the two phenomena in this group of patients. One hundred consecutive patients (mean age 57 +/- 14 years) referred for mitral balloon (Inoue) dilation were studied prospectively with transthoracic and transesophageal (83 biplane and 17 single plane) echocardiography (TEE) combined with spectral and color Doppler modalities, immediately before the procedure. TEE was repeated within 24 hours of valvotomy in the first 55 patients. ⋯ Both patients had left atrial SEC and one had thrombus in the appendage. It is concluded that SEC in patients with severe mitral stenosis is dependent on left atrial systolic function and peak systolic pulmonary vein velocity. It is not related to mitral valve area or anticoagulant therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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J Am Soc Echocardiogr · Sep 1994
Case ReportsDoppler echocardiographic evaluation of severe rheumatic submitral valve stenosis.
The submitral apparatus may play a predominant role in rheumatic mitral stenosis and should be evaluated aggressively with Doppler echocardiography, especially in patients in whom percutaneous mitral balloon valvotomy is being considered. The following case presents a patient with rheumatic mitral valve stenosis in whom some noninvasive clues alerted us to the presence of predominant submitral stenosis.
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J Am Soc Echocardiogr · Sep 1994
Case ReportsTransesophageal echocardiographic artifact mimicking pseudoaneurysm of the aorta.
Transesophageal echocardiography (TEE) is a sensitive and specific procedure that gives detailed images of the thoracic aortic anatomy and blood flow; however, there are few reports on pitfalls with TEE. This case describes a patient with a typical history of a possible aortic rupture; artifacts in the TEE mimicked aortic rupture and development of a pseudoaneurysm. Echocardiographers should know this possible pitfall to make the correct diagnosis.
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J Am Soc Echocardiogr · Sep 1994
Assessment of right-to-left shunt flow in atrial septal defect by transesophageal color and pulsed Doppler echocardiography.
To investigate the clinical significance and problems of right-to-left (R-L) shunt flow dynamics in atrial septal defects, we performed transesophageal color and pulsed Doppler echocardiography in 30 patients with atrial septal defects of the ostium secundum type. The 30 patients consisted of 20 with a pulmonary artery systolic pressure of less than 40 mm Hg, four with a pressure of 40 to 60 mm Hg, three with a pressure of 90 mm Hg or more, two patients with pulmonic stenosis, and one patient with Ebstein's anomaly. R-L shunting was determined by the presence of a shunt flow signal across the defect during each cardiac cycle. ⋯ In two of the three patients with severe pulmonary hypertension, R-L shunting continued from atrial systole to early ventricular systole and was also observed in early diastole. R-L shunt flow was detected in patients with atrial septal defects not only with pulmonary hypertension but also without pulmonary hypertension and was influenced by the right atrial pressure in the phase of tricuspid valve closing, the volume or direction of tricuspid regurgitation, rebound flow caused by massive left-to-right shunt flow, the grade of right ventricular distensibility or the complication of pulmonary hypertension, and complications with other cardiac anomalies. Thus R-L shunt flow in patients with atrial septal defects was detected easily by transesophageal color and pulsed Doppler echocardiography because of the high efficiency of this method for its detection.
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J Am Soc Echocardiogr · Sep 1994
Morphology of the mitral valve as displayed by multiplane transesophageal echocardiography.
This study was performed to (1) describe how multiplane transesophageal echocardiography (TEE) facilitates imaging of the entire mitral valve apparatus, and (2) prospectively compare the morphology of the different segments of the mitral apparatus as determined by multiplane TEE and direct surgical inspection. The study consisted of 30 consecutive patients examined by multiplane TEE less than 24 hours before mitral valve surgery. ⋯ The character and location of morphologic abnormalities identified by findings of preoperative TEE were highly concordant with surgical inspection of the valve (p < 0.0001). Thus multiplane TEE offers the ability to visualize the entire mitral apparatus as a functional unit and to identify morphologic abnormalities of the valve correctly.