Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Jan 1992
Case ReportsRight-to-left shunt through a patent foramen ovale caused by severe tricuspid regurgitation detected with color Doppler echocardiography.
We describe a 65-year-old patient with moderate combined mitral disease and severe tricuspid regurgitation, in whom the tricuspid regurgitant jet was oriented toward the interatrial septum. Color flow and pulsed Doppler demonstrated a late-systolic to mid-diastolic, right-to-left shunting of the tricuspid regurgitant jet through the foramen ovale. This finding was subsequently confirmed with transesophageal echocardiography.
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To determine whether transesophageal echocardiography (TEE) is useful in ruling out the presence of atrial thrombus, we performed TEE in 20 patients immediately before valve replacement or valve repair and within 3 days of an autopsy in one patient. Mitral stenosis was the predominant lesion in three patients, mitral regurgitation was seen in 11 patients, five patients had mitral prosthesis malfunction, one patient had a tricuspid prosthesis malfunction, and one patient had aortic stenosis. Eight patients were in atrial fibrillation. ⋯ TEE demonstrated a left atrial thrombus in two patients and a right atrial thrombus in another (confirmed at the time of surgery or at autopsy). In all cases transthoracic echocardiography was negative. Our data suggest that TEE is useful in ruling out atrial thrombus, and therefore may be a useful test preceding interventions associated with an increased risk of embolism from the atria such as cardioversion, mitral valvuloplasty, or valve replacement.
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J Am Soc Echocardiogr · Jan 1992
Case ReportsComplementary role of two-dimensional and Doppler echocardiography in the diagnosis of left ventricular free-wall rupture.
We describe a case of left ventricular free-wall rupture of the heart in which the use of two-dimensional and Doppler echocardiography provided the diagnosis. The echocardiographic findings in this condition are discussed and a previously unreported finding is described.
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J Am Soc Echocardiogr · Nov 1991
Intracardiac two-dimensional echocardiography in patients with pericardial effusion and cardiac tamponade.
The utility of intracardiac two-dimensional echocardiography in the identification of pericardial effusion was assessed in five patients with pericardial effusion and cardiac tamponade. A 20 MHz, mechanically rotating ultrasound catheter was used for intracardiac imaging. In all five patients, intracardiac echocardiography yielded high resolution of images of the right atrial cavity, the right atrial wall, and the pericardial effusion. ⋯ After pericardiocentesis, the reduction in the size of the effusion and increase in the right atrial cavity size could be recognized by intracardiac echocardiography. The introduction and manipulation of the ultrasound catheter was easily performed without any complications. This experience presents one clinical application for intracardiac echocardiography and indicates its potential value in the invasive cardiac laboratory.
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J Am Soc Echocardiogr · Nov 1991
Comparative StudyComparison of intraoperative transesophageal echocardiography to epicardial imaging in children undergoing ventricular septal defect repair.
Intraoperative transesophageal echocardiography was compared with epicardial echocardiography after ventricular septal defect repair. This comparison was made in 18 children aged 7 to 137 months (median, 32 months), weighing 6.3 to 49.1 kg (median, 10.8 kg) from November 1989 to January 1991. Ventricular septal defect types were perimembranous (six), malalignment (seven), supracristal (three), midmuscular (one), and inlet (one). ⋯ The missed defects were different with each technique and were confirmed by postoperative surface echocardiography. No residual defects of sufficient size to require reoperation were found as determined by combination color flow jet analysis and intraoperative oximetry (no pulmonary to systemic flow ratio was greater than 1.50). Patches caused two-dimensional and Doppler signal masking, but this was not limiting because all residual defects were found at the margins of the ventricular septal defect patch.(ABSTRACT TRUNCATED AT 250 WORDS)