Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Mar 2003
Comparative StudyLeft ventricular remodeling, mechanics, and tissue characterization in congenital aortic stenosis.
As the response of the myocardium to pressure overload is age-dependent, this study was designed to examine left ventricular (LV) remodeling, mechanics, and tissue characterization in children with moderate congenital aortic stenosis. ⋯ In children with moderate congenital aortic stenosis, the total amount of myocardial collagen was increased despite normal LV myocardial contractility and diastolic function. Furthermore, LV remodeling was abnormal in only about a quarter of our patients and none had more than mild hypertrophy. Although the majority of these patients do not have markers now recognized to predict higher risk of cardiovascular events, the long-term significance of myocardial fibrosis and its response to treatment remain to be investigated.
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J Am Soc Echocardiogr · Feb 2003
Case Reports Comparative StudyPenetrating aortic atherosclerotic ulcer complicated by periesophageal hematoma.
Penetrating aortic atherosclerotic ulcers have been recently recognized as an entity among the acute aortic syndromes with a potentially fatal outcome. We describe the case of a patient presenting with severe chest pain who died as a result of a thoracic-aorta penetrating atherosclerotic ulcer complicated by a intramural hematoma of the esophagus and stomach, leading to exsanguination. To our knowledge this is the first case reported in the literature of such a complication from penetrating aortic atherosclerotic ulcers.
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J Am Soc Echocardiogr · Dec 2002
Case ReportsIntraoperative transesophageal echocardiographic assessment of acute prosthetic aortic valve regurgitation after mitral valve replacement: value of the deep transgastric long-axis view.
The transesophageal echocardiographic assessment of prosthetic aortic valve function is made more difficult by the presence of a mechanical mitral valve prosthesis because echocardiographic views conventionally used to assess the aortic valve function are obscured by acoustic shadowing and artifacts. We report the use of intraoperative transesophageal echocardiography in a patient who developed severe prosthetic aortic valve regurgitation after implantation of a mechanical mitral valve, in whom conventional multiplane midesophageal views failed to reveal aortic regurgitation owing to acoustic shadowing and artifacts from the prosthetic mitral valve. We report the value of the deep transgastric long-axis view of the aortic valve that provided an unobstructed view of the left-ventricular outflow tract, and clearly demonstrated severe aortic regurgitation as a result of interference with the prosthetic aortic valve mechanism by the implanted mitral valve prosthesis. This case also emphasizes the importance of a comprehensive intraoperative transesophageal examination, including that of surrounding structures, to detect iatrogenic complications during mitral valve replacement.
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J Am Soc Echocardiogr · Nov 2002
Comparative StudyContinuous recording of pulmonary artery diastolic pressure and cardiac output using a novel ultrasound transducer.
The feasibility of hands-free transthoracic continuous determination of pulmonary artery (PA) diastolic pressure (PAD) and cardiac output (CO) by Doppler ultrasound has not been previously demonstrated. We developed a 2.5-MHz spherical transducer mounted in an external housing to permit steering in 360 degrees (Contison). The external housing was attached to the chest wall using an adhesive patch. ⋯ The 2.5-MHz spherical transducer permitted accurate assessment of CO and PAD. This transducer could be of potential value in monitoring patients in the intensive care setting.
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J Am Soc Echocardiogr · Nov 2002
Case ReportsAortic dissection with aorto-left atrial fistula formation soon after aortic valve replacement: A lethal complication diagnosed by transthoracic and transesophageal echocardiography.
Fistulas between the aorta and left atrium are a rare manifestation of aortic dissection and are infrequently diagnosed premortem. We report the case of a 70-year-old man who exhibited this condition soon after aortic valve replacement and eventually died from rapidly developing refractory congestive heart failure. The diagnosis was indicated by transthoracic echocardiography and was ultimately made with transesophageal echocardiography and color flow Doppler imaging. Transesophageal echocardiography is the procedure of choice for establishing the correct diagnosis and leading to prompt surgical repair of this lethal condition.