Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Mar 1993
Case ReportsAortic dissection complicating cardiac surgery: diagnosis by intraoperative biplane transesophageal echocardiography.
Aortic dissection is a rare but devastating complication of cardiopulmonary bypass. Intraoperative transesophageal echocardiography can be a useful technique to define the anatomy of the dissection, to evaluate its extension and progression, and to detect the presence of aortic insufficiency. We describe two cases in which transesophageal echocardiography helped in making a rapid diagnosis of aortic dissection during cardiac surgery and demonstrate how it may play a role in therapeutic decision making.
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J Am Soc Echocardiogr · Jan 1993
Value and limitations of transesophageal echocardiography in the evaluation of aortic prostheses.
Results of 34 transesophageal (TEE) studies in patients with suspected aortic prosthetic dysfunction were compared with transthoracic echocardiographic (TTE) results and to anatomic findings. Mass lesions noted at surgery (autopsy) were correctly described in 93% by TEE versus 43% by TTE. ⋯ Anatomic aortic regurgitant lesions were identified in 96% by TEE versus 77% by TTE, whereas the correct origin was detected in 88% of cases by TEE versus 54% of cases by TTE. TEE provides valuable additional information on morphologic conditions and flow pathology in aortic valve prostheses.
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J Am Soc Echocardiogr · Jan 1993
Case ReportsDouble cardiomyopathy: coexistent cardiac amyloidosis and hypertrophic obstructive cardiomyopathy.
A combination of hypertrophic obstructive cardiomyopathy (HOCM) and cardiac amyloidosis in the same patient is very rare. Clinical diagnosis could be extremely difficult and may require myocardial biopsy. ⋯ Only after the patient expired from severe, intractable heart failure did the autopsy findings confirm the association of HOCM. We believe that the combination of the two cardiomyopathic processes is very rare and makes treatment extremely difficult.
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J Am Soc Echocardiogr · Nov 1992
Does inferior vena cava size predict right atrial pressures in patients receiving mechanical ventilation?
The inferior vena cava diameter and its respiratory response are used to estimate right atrial pressures in spontaneously breathing patients but its value in patients receiving mechanical ventilation is unvalidated. Forty-nine patients undergoing mechanical ventilation were prospectively evaluated in the intensive or coronary care units with two-dimensional echocardiography of the inferior vena cava and simultaneous measurements of mean right atrial pressures by central venous or pulmonary artery catheter. ⋯ Despite these correlations, an inferior vena cava diameter of < or = 12 mm predicted a right atrial pressure of 10 mm Hg or less 100% of the time, but sensitivity was only 25%. An inferior vena cava diameter > 12 mm had no predictive value for right atrial pressure.
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J Am Soc Echocardiogr · Sep 1992
Case ReportsBlood cyst of the mitral valve: detection by transthoracic and transesophageal echocardiography.
Two-dimensional transthoracic and transesophageal echocardiography have become important modalities in the evaluation of the mechanism of symptomatic mitral regurgitation. We report the use of echocardiography in the detection of an unusual cause of mitral regurgitation, that of multiple large blood cysts involving the posterior leaflet of the mitral valve.