American heart journal
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American heart journal · Sep 1994
Comparative StudyQuantitation of aortic valve area in aortic stenosis with multiplane transesophageal echocardiography: comparison with monoplane transesophageal approach.
The accuracy and reliability of two-dimensional monoplane and multiplane transesophageal echocardiography (TEE) in the quantitation of aortic valve area were compared in 54 patients with aortic stenosis. Fifty patients had aortic valve area calculated by the continuity equation and transthoracic Doppler echocardiography (TTE); 25 underwent cardiac catheterization. Two-dimensional echocardiograms adequate for quantitation of aortic valve area were obtained in 21 (39%) patients with monoplane TEE and in 51 (94%) with multiplane TEE. ⋯ Multiplane TEE provided a better correlation of aortic valve area measurements with either TTE (y = 0.97 x + 0.03; r = 0.96; SEE = 0.11 cm2) or catheterization (y = 0.84 x + 0.11; r = 0.90; SEE = 0.12 cm2) than the monoplane TEE (y = 0.88 x + 0.13; r = 0.83; SEE = 0.15 cm2 and y = 0.41 x + 0.42; r = 0.81; SEE = 0.15 cm2). Severe aortic stenosis with valve orifice area of < or = 0.75 cm2 during TTE examination was found by multiplane TEE with a sensitivity of 96% and a specificity of 96%. Thus aortic valve area can be directly and reliably measured by two-dimensional multiplane TEE in majority of patients with aortic stenosis.
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American heart journal · Sep 1994
Retrograde coronary blood flow during cardiopulmonary resuscitation in swine: intracoronary Doppler evaluation.
Cardiopulmonary resuscitation-generated coronary perfusion pressure and intracoronary flow velocity was studied with high-fidelity pressure transducers and an intracoronary Doppler catheter in 11 swine undergoing closed-chest manual cardiopulmonary resuscitation. Retrograde coronary blood flow in the mid left anterior descending coronary artery was documented during the compression (systolic) phase of chest compression. ⋯ Even when the aortic minus right atrial pressure gradient was raised throughout the cardiac cycle of closed-chest manual cardiopulmonary resuscitation, antegrade coronary flow occurred only during the relaxation phase of chest compressions. This study indicates that coronary blood flow during ventricular fibrillation and closed-chest cardiopulmonary resuscitation occurs only during diastole or the release phase of chest compression and supports the use of diastolic coronary perfusion pressure as a reflection of myocardial blood flow during closed-chest manual cardiopulmonary resuscitation.