Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Nov 1991
Case ReportsTransesophageal echocardiographic guidance of balloon atrial septostomy.
Two newborn infants with transposition of the great vessels and an intact ventricular septum were cyanotic when they underwent bedside balloon atrial septostomy in the neonatal intensive care unit. The procedure was conducted under direct transesophageal two-dimensional echocardiographic guidance. ⋯ Transesophageal echocardiography has several advantages over transthoracic echocardiography in aiding this procedure. It provides an optimal view of the atrial septum, while keeping the chest exposed for observation of respiratory effort and for improved thermoregulation.
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J Am Soc Echocardiogr · Sep 1991
ReviewDoppler flow velocity patterns of the superior vena cava, inferior vena cava, hepatic vein, coronary sinus, and atrial septal defect: a guide for the echocardiographer.
Pulsed-wave Doppler provides the echocardiographer the advantage of range resolution; confusion as to the source of Doppler shift information is unusual. One area of the heart that may lead to interpretive difficulties, however, is the right atrium because the right atrium receives blood flow from three venous sources and from the left atrium when an atrial septal defect is present. Our article presents information on the normal pulsed-wave Doppler spectral displays for the superior vena cava, inferior vena cava, hepatic vein, and coronary sinus. Because it is clinically pertinent, methods on how to differentiate these normal venous flow patterns from atrial septal defect flow will be emphasized.
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J Am Soc Echocardiogr · Sep 1991
Case ReportsUnruptured noncoronary sinus of Valsalva aneurysm: preoperative characterization by transesophageal echocardiography.
We describe a patient with a large unruptured sinus of Valsalva aneurysm that was discovered incidentally. Transesophageal echocardiography was used to characterize the aneurysm preoperatively, and was helpful intraoperatively in assessment of the degree of native aortic valvular regurgitation after repair. The use of transthoracic echocardiography, contrast echocardiography, Doppler echocardiography, and transesophageal echocardiography are discussed in this condition.
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J Am Soc Echocardiogr · Jul 1991
Case ReportsLeft atrial tamponade: diagnosis by transesophageal echocardiography.
A 60-year-old white man became hypotensive and dyspneic 3 days after right pneumonectomy for bronchogenic carcinoma. Transthoracic echocardiography was nondiagnostic because of technical difficulty. ⋯ The hemodynamic disturbance resolved after drainage of the effusion. Transesophageal echocardiography plays a valuable role in the diagnosis of postoperative cardiac tamponade.
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J Am Soc Echocardiogr · May 1991
Predicting left heart failure after a myocardial infarction: a preliminary study of the value of echocardiographic measures of left ventricular filling and wall motion.
Heart failure occurs from both systolic and diastolic dysfunction. To determine whether simple Doppler echocardiographic measures of left ventricular filling could improve upon the ability of systolic function to predict heart failure after infarction, patients with acute myocardial infarction were studied within the first 36 hours by Doppler and two-dimensional echocardiography. ⋯ However, the only independent predictors of heart failure by use of multivariant stepwise logistic regression analysis were the wall motion score index (p less than 0.05) and either the ratio of early and late peak filling velocities (p less than 0.001) or the percentage of filling with atrial systole (p less than 0.001). The combined use of a measure of systolic function and measures of the relative contribution of atrial systole to ventricular filling were useful predictors in identifying patients likely to develop subsequent heart failure after myocardial infarction.