Assuntos
Humanos , Masculino , Adolescente , Estenose da Valva Pulmonar/etiologia , Estenose da Valva Pulmonar/diagnóstico por imagem , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico , Estenose da Valva Pulmonar/congênito , Toracoscopia/métodos , Dor no Peito/complicações , Ecocardiografia/métodos , Radiografia Torácica/métodos , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Tratamento Farmacológico/métodos , Dispneia/complicações , Neoplasias/classificaçãoAssuntos
Humanos , Feminino , Adulto , Estenose da Valva Pulmonar/diagnóstico por imagem , Dupla Via de Saída do Ventrículo Direito/diagnóstico por imagem , Comunicação Interventricular/diagnóstico por imagem , Aorta/diagnóstico por imagem , Estenose da Valva Pulmonar/fisiopatologia , Dupla Via de Saída do Ventrículo Direito/fisiopatologia , Ecocardiografia , Espectroscopia de Ressonância Magnética , Radiografia Torácica , Diagnóstico Diferencial , Eletrocardiografia , Comunicação Interventricular/fisiopatologiaAssuntos
Humanos , Feminino , Idoso , Estenose da Valva Pulmonar/cirurgia , Cateterismo Cardíaco/instrumentação , Estenose da Valva Pulmonar/fisiopatologia , Estenose da Valva Pulmonar/diagnóstico por imagem , Angiografia/métodos , Cateterismo Cardíaco/métodos , Radiografia Torácica , Resultado do Tratamento , Disfunção Ventricular Direita/cirurgia , Disfunção Ventricular Direita/fisiopatologia , EletrocardiografiaRESUMO
Transesophageal echocardiography has been shown to provide unique information about cardiac anatomy, function, hemodynamics and blood flow and is relatively easy to perform with a low risk of complications. Echocardiographic evaluation of the tricuspid and pulmonary valves can be achieved with two-dimensional and Doppler imaging. Transesophageal echocardiography of these valves is more challenging because of their complex structure and their relative distance from the esophagus. Two-dimensional echocardiography allows an accurate visualization of the cardiac chambers and valves and their motion during the cardiac cycle. Doppler echocardiography is the most commonly used diagnostic technique for detecting and evaluating valvular regurgitation. The lack of good quality evidence makes it difficult to recommend a validated quantitative approach but expert consensus recommends a clinically useful qualitative approach. This review ennumerates probe placement, recommended cross-sectional views, flow patterns, quantitative equations including the clinical approach to the noninvasive quantification of both stenotic and regurgitant lesions.
Assuntos
Ecocardiografia Doppler em Cores , Ecocardiografia Doppler de Pulso , Ecocardiografia Transesofagiana/métodos , Humanos , Valva Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/diagnóstico por imagem , Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/diagnóstico por imagem , Estenose da Valva Tricúspide/diagnóstico por imagemRESUMO
Pallister-Killian syndrome (PKS) is a rare disorder characterized cytogenetically by tetrasomy 12p for isochromosome of the short arm of chromosome 12. PKS is diagnosed by prenatal genetic analysis through chorionic villous sampling, genetic amniocentesis, and cordocentesis, or by chromosomal analysis of skin fibroblasts, but is not usually detected by chromosomal analysis of peripheral blood cells. Herein, we report a case of a gravida at 23 weeks gestation with pulmonary stenosis and right ventricular dilation of the heart which were detected by sonography. Fluorescence in situ hybridization and a multicolor banding technique were performed to verify the diagnosis as 47,XX, +mar.ish i(12)(p10)(TEL++)[16]/46,XX[4], and an autopsy confirmed the cardiac anomalies detected on antenatal sonography.
Assuntos
Adulto , Feminino , Humanos , Gravidez , Aberrações Cromossômicas , Cromossomos Humanos Par 12 , Doenças Fetais/diagnóstico , Idade Gestacional , Hibridização in Situ Fluorescente , Cariotipagem , Diagnóstico Pré-Natal , Estenose da Valva Pulmonar/diagnóstico por imagem , Disfunção Ventricular Direita/diagnóstico por imagemRESUMO
Bioprostheses frequently become calcified and stenosed, especially when implanted in younger patients. The general recommendation in such cases is to repeat surgery. Balloon valvuloplasty has hitherto been attempted with mixed success. Calcification and limitation of the balloon size due to the valve ring can lead to suboptimal long-term results. We report a case where balloon dilation of the stenosed bioprosthesis at pulmonary position was successfully performed with good immediate result. Cardiac catheterization after 3 years showed only a minimal increase (5 mmHg) in the gradient.
Assuntos
Anormalidades Múltiplas/diagnóstico , Adulto , Angioplastia com Balão/métodos , Bioprótese/efeitos adversos , Ecocardiografia Doppler , Seguimentos , Cateterismo Cardíaco , Cardiopatias Congênitas/diagnóstico , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Masculino , Falha de Prótese , Artéria Pulmonar , Estenose da Valva Pulmonar/diagnóstico por imagem , Medição de Risco , Resultado do TratamentoRESUMO
Pulmonary artery (PA) trunk or branch PA stenosis is commonly found in patients with congenital heart disease. The aim of the present study was to evaluate the freehand "Flock of Birds" color Doppler three-dimensional (3D) reconstruction on a modeled-segment imitating PA stenosis. First, a PA model was created from latex tubes to simulate the main PA and its main branches with baseline cross-sectional areas (CSA) of 0.7 cm2. A series of narrowed segments in the right and left PA were created. The cross-sections of the smallest area ranged from 0.13 to 0.59 cm2 and stenotic segmental length ranged from 0.17 to 1.80 cm. The dimensions of these elements mounted on to the model were verified by intravascular ultrasound (IVUS) imaging. Next, pulsatile flows at 60 beats/ min were generated through the system. A GE/VingMed System FiVe with magnetic locator system (Flock of Birds) on a 3.5 MHz transducer was used to acquire a freehand sweep for ECG gated 3D data acquisition of color Doppler flows through the model. The images were reconstructed by EchoPac 3D software and the morphology of the stenotic elements were determined. The results revealed that the narrowest CSA determined by the 3D color flow cast of the pulmonary artery were in excellent agreement with IVUS CSA (r = 0.98, p < 0.001, SEE = 0.04 cm2). The stenotic length estimated from 3D was also in good agreement with the IVUS (r = 0.98, p < 0.001, SEE = 0.03 cm). In addition, complex morphology of the stenosis was well visualized by this technique. As a result, the noninvasive free-hand digital color 3D echocardiography can be adopted for the accurate assessment of the severity and morphology of PA stenosis in patients with congenital heart diseases.
Assuntos
Ecocardiografia Doppler em Cores/métodos , Ecocardiografia Tridimensional/métodos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Modelos Cardiovasculares , Artéria Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/diagnóstico por imagem , Processamento de Sinais Assistido por ComputadorRESUMO
Two dimensional echocardiographic measurements of the size of aortic and pulmonary valve annulus were made in 60 patients before balloon valvoplasty and compared to the angiographic measurements. Aortic valve annulus was measured in 34 patients (26 with valvar aortic stenosis and 8 with discrete subaortic stenosis) in the parasternal long axis or apical 5-chamber views. The pulmonary valve annulus was measured in 26 patients with valvar pulmonary stenosis (PS) in the parasternal short axis view of the right ventricular outflow view. The visualization of the annulus was good in all except 2 patients with valvar PS. Angiographic measurements of the aortic and pulmonary valve annulus were made in aortic root and right ventricular angiograms respectively, taken in both right and left anterior oblique views. There was an excellent correlation between the measurements of the annulus size by the two techniques (r value for pulmonary valve 0.91; for aortic valve 0.96; over all 0.94). Echocardiography can accurately measure valve annulus size and help in choosing balloon dilatation catheter of appropriate size before the valvoplasty procedure.