Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Jan 1994
Case ReportsPapillary muscle rupture caused by bacterial endocarditis: role of transesophageal echocardiography.
A 22-year-old man had severe pulmonary congestion and required mechanical ventilation. Endocarditis was suspected because a 2/6 systolic murmur was heard at the apex and because Osler nodes were present. Transthoracic and transesophageal echocardiography allowed correct diagnosis of papillary muscle rupture causing massive mitral regurgitation. To our knowledge, this is the first reported case of papillary muscle rupture caused by bacterial endocarditis diagnosed by transthoracic and transesophageal echocardiography.
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J Am Soc Echocardiogr · Jan 1994
Regurgitant flow of mitral valve prostheses: an intraoperative transesophageal echocardiographic study.
To assess the regurgitant characteristics of mitral biologic and mechanical prostheses immediately after implantation, intraoperative transesophageal echocardiography was performed in 27 patients, aged 32 to 69 years, undergoing open-heart surgery for rheumatic heart disease (n = 19), mitral valve prolapse (n = 3), malfunctioning prostheses (n = 3), or periprosthetic leaks (n = 2). The prostheses included 13 biologic (Carpentier-Edwards) and 14 mechanical valves (five Starr-Edwards, five Medtronic-Hall, and four Bjork-Shiley). Physiologic transvalvular regurgitant flow was detected in both biologic and mechanical prostheses. ⋯ In one patient a PPJ was judged extensive enough (area 3.6 cm2) to warrant surgical revision of the implant, but no dehiscence was found. In the other patient a turbulent PPJ (area 5.5 cm2) was associated with a 0.5 cm dehiscence at the surgical inspection. In conclusion, (1) all mitral prostheses exhibit physiologic transvalvular regurgitation, (2) trivial mitral PPJ is a common finding in newly implanted mitral valves and does not require the revision of the implant, and (3) further experience based on larger series of patients is required to determine the maximal acceptable size of a mitral PPJ detected by intraoperative transesophageal echocardiography.
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A 35-year-old woman had infective endocarditis and an aneurysm of the anterior mitral leaflet. The patient was managed conservatively and the mitral valve aneurysm remained stable over 3 years. Two-dimensional, color flow Doppler, and magnetic resonance images of the aneurysm are presented and features of mitral valve aneurysms are discussed. Conservative management of mitral valve aneurysms with careful follow-up is an acceptable approach.
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J Am Soc Echocardiogr · Nov 1993
Case ReportsHiatal hernia: the "X" factor in transesophageal echocardiography.
Two patients with large hiatal hernias underwent transesophageal echocardiographic examinations. In one case adequate images could not be obtained. In the other, skewed images and misleading information required other modes of investigation. We propose that the presence of a large hiatal hernia may lead to poor images or total inability to collect sonographic data.
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J Am Soc Echocardiogr · Nov 1993
ReviewAorta: comprehensive evaluation by echocardiography and transesophageal echocardiography.
The emergence of transesophageal echocardiography has made echocardiography a nearly ideal technique for evaluating the thoracic aorta. The echocardiographic anatomy of the aorta is reviewed. The role of echocardiography for evaluating aortic dissection, thoracic aortic aneurysm, aortic atherosclerosis, and thoracic aortic trauma is discussed. Comparison of echocardiography with other techniques for imaging the aorta (computed tomographic scan, nuclear magnetic resonance, and aortography) is presented.