[Echocardiographic abnormalities of the mitral valve in interatrial communication of the ostium secundum type]. / Anormalidades ecocardiográficas de la válvula mitral en la comunicación interauricular tipo ostium secundum.

Thirty one patients with atrial septal defect were studied by M-mode echocardiography. In sixteen patients (control group) there only findings suggesting right ventricular volume overload. The remaining fifteen patients, were divided into three groups. Group 1 consisted of five patients with mitral valve abnormalities related to the left ventricular pattern. The macroscopic aspect of the mitral valve in this group was reported by the surgeon to be rheumatic or myxomatous degeneration. In four patients (group II), there was prolapse of an atrioventricular valve, three mitral and one tricuspid. Group III consisted of six patients with an abnormal movement of the posterior mitral leaflet, related to a deformed left ventricle. The QP/QS ratio as well as the interatrial shunt was larger in groups I and III. These data suggest that there are abnormal mitral flow patterns and changes in the left ventricular geometry, related to right ventricular volume overload that cause altered mitral valve movement that can be detected by echocardiography.

[Echocardiographic study of different forms of pulmonary atresia]. / Estudio ecocardiográfico de las differentes formas de atresia pulmonar.

Echocardiographic recognition of pulmonary atresia with either ventricular septal defect or intact ventricular septum is of great value in the differential diagnosis with other forms of right ventricular outflow tract obstruction or hypoplasia of the right ventricle. We studied nine patients with pulmonary atresia seven with ventricular septal defect and two with intact ventricular septum. It was not possible in either group of these patients to register systolic opening and diastolic closure movements of the pulmonary valve. In the group with ventricular septal defect, aortic straddling was present in all cases. In one patient it was possible to register the echoes of an imperforated pulmonary valve. In the remaining patients, the differential diagnosis with persistent truncus arteriosus was not possible. M-mode and Two-dimensional echocardiographic features of pulmonary atresia with intact ventricular septum are specific of this malformation and can differentiate it from other forms of hypoplasia of the right ventricle.

Anormalidades ecocardiograficas de la valvula mitral en la comunicacion interauricular tipo ostium secundum. / Echocardiographic abnormalities of the mitral valve in patients with atrial septal defect

Se estudiaron con ecocardiografia modo-M, 31 pacientes con comunicacion interauricular, patologia comprobada por cateterismo y/o cirugia. Dieciseis de ellos formaron el grupo control y en sus ecocardiogramas exclusivamente se encontraron datos de sobrecarga de volumen del ventriculo derecho. De los 15 pacientes restantes, se hicieron III grupos: en el grupo I, cinco tuvieron anormalidades valvulares mitrales, las cuales no se relacionaron con el patron de contractilidad del ventriculo izquierdo. Durante la cirugia, el aspecto externo de las valvulas se informo como sugestivo de lesion reumatica o degeneracion fibromixomatosa. En el grupo II, de 4 pacientes, existia prolapso de una de las valvulas atrioventriculares; en tres era de la mitral y en uno de la tricuspide. El grupo III se formo con 6 pacientes que tenian movilidad anormal de la valva mural mitral, secundaria a la deformidad del ventriculo izquierdo. La relacion gasto pulmonar/gasto sistemico asi como el cortocircuito interauricular fue mayor en los grupos I y III. Con los datos obtenidos se sugiere que existen alteraciones en los patrones de flujo atrio-ventricular y cambios en la geometria del ventriculo izquierdo, condicionados por la sobrecarga de volumen del ventriculo derecho los que provocan anormalidades en la movilidad de la valvula mitral detectables por ecocardiografia