Comparison of biplane and monoplane transesoplageal echocardiography in the diagnosis of atrial septal defect in adult patients

The study included 30 patients, they were divided into 2 groups. Group I included 20 patients with atrial septal defect [ASD] in different forms. The other 10 patients [in group II] did not have ASD but they had other cardiac lesions and enrolled in the study as a control group. When the transverse plane transducer was used for the examination of group I patients, it was able to detect and accurately and correctly localize all the atrial septal defects in this group with no false negative [-ve] results. On examining group II patients, the transverse plane was able to exclude the presence of an ASD in all cases with no false positive [+ve] results. When the longitudinal plane transducer was used in group I patients, all the 20 atrial septal defects were detected with no false -ve results. On examining group II patients, the longitudinal plane was also able to exclude the presence of ASD in this group with no false +ve results. This newly added plane [the vertical plane] did not have additional value in the diagnosis and accurate localization of ASD in adults

Initial experience with native coarctation balloon angioplasty

Balloon angioplasty was performed in 13 patients with native coarctation of the aorta from November 1988 to October 1989. The patients ranged in age from 4 to 25 years with a mean of 13 years There were 7 females and 6 males. Four patients had associated aortic valvular stenosis; 2 of those had their aortic valves dilated during the procedure. The mean systolic pressure gradient across the coarctation dropped from 67 +/- 29 to 9.6 +/- 12.6 mmHg immediately after angioplasty. The mean diameter of the coarcted segment increased from 6.7 + 2.7 to 13.65 + 2.8 mm. The balloon size was chosen so that its diameter was equal to or 1 - 2 mm less than the diameter of the descending thoracic aorta at the level of the diaphragm, after correction for magnification. The diameter of the balloons used ranged from 12 to 20 mm while the balloon length ranged from 3 to 5.5 cm. One 15 years old male developed a right femoral arterio - venous fistula after the procedure, that was confirmed by subsequent angiography and he was scheduled for surgery. The initial results look promising and follow up of the patients is currently taking place for defining the exact role of angioplasty in dilating native coarctations