Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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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.
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J Am Soc Echocardiogr · Nov 1993
Improved echocardiographic detection and characterization of left ventricular apical thrombi with a 5.0 MHz short-focus transducer.
Transthoracic echocardiography is a frequently used technique for detecting ventricular thrombi. This study compares the usefulness of a 5.0 MHz short focal length transducer (5-short) with standard frequency (2.5 or 3.5 MHz) transducers for the detection of left ventricular thrombi. In addition, the effect of body habitus on study quality was evaluated. ⋯ The studies positive only with the 5-short had significantly smaller calculated thrombi areas than those visualized by the standard transducers (1.6 +/- 1.2 vs 4.2 +/- 2.1 cm2, p = 0.02). No thrombus was detected by either technique in a normally contracting left ventricular apex. There were significantly fewer studies having near-field artifact when performed by the 5-short compared with those performed with standard transducers (14/101 vs 40/101, p = 0.00004).(ABSTRACT TRUNCATED AT 250 WORDS)
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J Am Soc Echocardiogr · Jul 1993
Case ReportsA large left ventricular thrombus evolving towards canalization and mimicking a left ventricular pseudoaneurysm: an echocardiographic study.
We describe a case of a large apical left ventricular thrombus evolving towards canalization and showing echocardiographic features mimicking a left ventricular pseudoaneurysm. Only serial echocardiographic studies allowed an appreciation of the changing morphologic features of the apical structure, permitting differential diagnosis between a canalization of an evolving thrombus and a myocardial free-wall rupture with pseudoaneurysm formation.
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J Am Soc Echocardiogr · Jul 1993
Transesophageal echocardiography during repair of congenital cardiac defects: identification of residual problems necessitating reoperation.
One advantage of intraoperative transesophageal echocardiographic (TEE) evaluation during surgery for congenital heart disease is detection of suboptimal repairs, thus providing the opportunity to return to cardiopulmonary bypass (CPB) to repair residual defects. The purpose of this study was to evaluate the impact of TEE on decisions to return to CPB. Two-hundred-thirty infants and children with a variety of defects were studied with size-appropriate TEE probes. ⋯ Although post-CPB TEE provided reassuring information in patients with other diagnoses, TEE impact on return to CPB appears to be significant in a small group of primary diagnoses. The sensitivity and specificity of TEE determination of the need for reoperation were 89% and 100%, respectively. By identifying the site, severity, and mechanism of residual problems, TEE offers substantial utility in detection of residual problems in need of reoperation.
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J Am Soc Echocardiogr · Mar 1993
Randomized Controlled Trial Clinical TrialA double-blind trial of glycopyrrolate for transesophageal echocardiography.
Glycopyrrolate is an anticholinergic agent used to dry oral secretions and has been advocated for routine use with transesophageal echocardiography (TEE). To evaluate the safety and efficacy of glycopyrrolate for this unique application, a prospective double-blind placebo-controlled study of glycopyrrolate was performed in 61 patients who were awake while undergoing TEE. Thirty patients were randomized to the standard dose of glycopyrrolate (0.2 mg intravenously), and 31 patients received 1 ml of saline solution as placebo. ⋯ A significantly higher incidence of the following side effects was observed at 24 hours in patients who received glycopyrrolate versus those who received placebo: sore throat, 63% versus 19%; dry mouth, 43% versus 6%; and urinary retention, 16% versus 0% (p < 0.05 for all). No benefit from glycopyrrolate was noted in operator ease or patient comfort. In conclusion, glycopyrrolate is not recommended for routine use when performing TEE on patients who are awake.