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1.
BMC Cardiovasc Disord ; 22(1): 36, 2022 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-35120434

RESUMO

BACKGROUND: Cardiac resynchronization therapy (CRT) is an accepted device treatment in stable heart failure (HF) patients. In recent years increased awareness of coronary anatomy and implantation techniques have significantly impacted this evolving therapy. CASE PRESENTATION: In this article, we present a case describing the usefulness of the proximal balloon anchoring technique to enable initial coronary sinus (CS) cannulization and left ventricular (LV) lead placement in the tortuous coronary sinus during CRT implantation. CONCLUSIONS: The proximal anchor balloon technique can easily enable coronary sinus cannulization and left ventricular lead placement in patients with complex venous anatomy.


Assuntos
Cateterismo Cardíaco/métodos , Dispositivos de Terapia de Ressincronização Cardíaca , Vasos Coronários/diagnóstico por imagem , Eletrocardiografia , Insuficiência Cardíaca/terapia , Idoso , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino
2.
Echocardiography ; 36(8): 1581-1585, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393624

RESUMO

Massive and submassive pulmonary thromboembolism carry significant morbidity and mortality. We present an elderly female who was diagnosed with a submassive pulmonary embolism by computed tomographic angiography and treated with ultrasound-facilitated thrombolysis (UFT). This case demonstrates the usefulness of right ventricular longitudinal strain measurements by two-dimensional speckle tracking echocardiography in the evaluation of right ventricular function before and after UFT. Evaluation of right ventricle longitudinal strain by speckle tracking echocardiography may supplement other parameters in the assessment of right ventricular function in these patients.


Assuntos
Artéria Pulmonar/diagnóstico por imagem , Embolia Pulmonar/diagnóstico , Terapia Assistida por Computador/métodos , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tecidual/uso terapêutico , Ultrassonografia/métodos , Angiografia por Tomografia Computadorizada , Ecocardiografia , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Pessoa de Meia-Idade , Embolia Pulmonar/tratamento farmacológico
3.
Indian Heart J ; 70(4): 497-501, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30170643

RESUMO

OBJECTIVE: Omega-3 fatty acids, especially alpha-linolenic acid (ALA), which are present in nuts may reduce cardiovascular disease (CVD) risk, by changing vascular inflammation and improving endothelial dysfunction. The objective of the study was to evaluate the acute effects of two different diets, one containing walnuts and the other almonds on endothelial function. METHODS: Twenty-seven overweight volunteers underwent a randomized 2-period, crossover, controlled intervention study. The subjects were given either walnut or almond diets which varied in monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) content. The walnut diet provided 23.1% energy from PUFA and the almond diet provided 7.6% energy from PUFA. Endothelial function was assessed physiologically by flow-mediated dilation (FMD) and biochemically by sVCAM (soluble vascular cell adhesion molecules). RESULTS: The walnut diet significantly improved FMD (p=0.004) and decreased sVCAM (p=0.009) whereas the almond diet tended to improve FMD (p=0.06) and significantly decreased sVCAM (p=0.004). CONCLUSION: Both walnut and almond diets improved FMD and sVCAM and there was no significant difference in physiological and biochemical markers between the two diets.


Assuntos
Endotélio Vascular/fisiopatologia , Juglans , Nozes , Sobrepeso/tratamento farmacológico , Óleos de Plantas/administração & dosagem , Prunus dulcis , Vasodilatação/efeitos dos fármacos , Adulto , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Estudos Cross-Over , Dieta/métodos , Feminino , Humanos , Masculino , Sobrepeso/complicações , Sobrepeso/fisiopatologia
4.
Echocardiography ; 33(10): 1581-1588, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27587344

RESUMO

The knowledge gained from echocardiography is paramount for the clinician in diagnosing, interpreting, and treating various forms of disease. While cardiologists traditionally have undergone training in this imaging modality during their fellowship, many other specialties are beginning to show interest as well, including intensive care, anesthesia, and primary care trainees, in both transesophageal and transthoracic echocardiography. Advances in technology have led to the development of simulation programs accessible to trainees to help gain proficiency in the nuances of obtaining quality images, in a low stress, pressure free environment, often with a functioning ultrasound probe and mannequin that can mimic many of the pathologies seen in living patients. Although there are various training simulation programs each with their own benefits and drawbacks, it is clear that these programs are a powerful tool in educating the trainee and likely will lead to improved patient outcomes.


Assuntos
Cardiologia/educação , Instrução por Computador/métodos , Ecocardiografia/métodos , Treinamento com Simulação de Alta Fidelidade/métodos , Manequins , Software , Instrução por Computador/instrumentação , Ecocardiografia/instrumentação , Imagens de Fantasmas , Avaliação da Tecnologia Biomédica
5.
W V Med J ; 112(2): 28-30, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27025115

RESUMO

PURPOSE: This report highlights the significance of endovascular training for invasive cardiologists. CASE REPORT: 78-year-old morbidly obese male with an inferior wall myocardial infarction underwent primary percutaneous coronary intervention (PCI) which was complicated by laceration of the profunda femoris artery. Endovascular repair of the profunda femoris artery was performed by using Jomed covered stents. CONCLUSION: This case report of endovascular repair of lacerated profunda femoris artery signifies the importance of endovascular training for invasive cardiologist.


Assuntos
Artéria Femoral/lesões , Artéria Femoral/cirurgia , Infarto do Miocárdio/cirurgia , Obesidade Mórbida/complicações , Intervenção Coronária Percutânea/efeitos adversos , Stents , Idoso , Índice de Massa Corporal , Humanos , Masculino , Infarto do Miocárdio/complicações , Resultado do Tratamento
6.
Vasc Health Risk Manag ; 9: 187-93, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23662064

RESUMO

BACKGROUND: A dual antiplatelet regimen has been shown to reduce the risk of major adverse cardiovascular events after percutaneous coronary intervention. However, there is little information available on inhibition of platelet aggregation in patients with a prior coronary stent presenting with chest pain. This study evaluated the prevalence of hyporesponsiveness to clopidogrel and factors associated with this in patients presenting to our emergency department with chest pain who had previously undergone coronary stent placement and were prescribed dual antiplatelet therapy. METHODS: Responsiveness to clopidogrel was evaluated in a cohort of 533 consecutive stented patients presenting to the emergency department with chest pain. P2Y12 reaction units (PRU) and percent P2Y12 inhibition with clopidogrel were measured in all patients. Of 533 patients, 221 (41.6%) had PRU ≥ 230. A multivariate logistic regression model was used to determine the relationship between hyporesponsiveness to clopidogrel (defined as PRU ≥ 230) and several potential risk factors, ie, gender, age, race, type 1 or type 2 diabetes, hypertension, smoking, chronic renal failure, and obesity. RESULTS: There was a greater risk of hyporesponsiveness in African Americans than in non-African American patients (adjusted odds ratio [OR] = 2.165), in patients with type 2 diabetes than in those without (adjusted OR = 2.109), and in women than in men (adjusted OR = 1.813), as well as a greater risk of hyporesponsiveness with increasing age (adjusted OR = 1.167 per decade). CONCLUSION: There was a high prevalence of hyporesponsiveness to clopidogrel in patients presenting with chest pain and a prior coronary stent. Non-insulin-dependent diabetes mellitus and African American race were the strongest predictors of hyporesponsiveness to clopidogrel, followed by gender and age.


Assuntos
Plaquetas/efeitos dos fármacos , Dor no Peito/etiologia , Serviço Hospitalar de Emergência , Inibidores da Agregação Plaquetária/uso terapêutico , Testes de Função Plaquetária , Antagonistas do Receptor Purinérgico P2Y/uso terapêutico , Ticlopidina/análogos & derivados , Negro ou Afro-Americano , Fatores Etários , Idoso , Plaquetas/metabolismo , Dor no Peito/sangue , Dor no Peito/etnologia , Clopidogrel , Diabetes Mellitus Tipo 2/complicações , Resistência a Medicamentos , Quimioterapia Combinada , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/instrumentação , Inibidores da Agregação Plaquetária/efeitos adversos , Valor Preditivo dos Testes , Estudos Prospectivos , Antagonistas do Receptor Purinérgico P2Y/efeitos adversos , Receptores Purinérgicos P2Y12/sangue , Receptores Purinérgicos P2Y12/efeitos dos fármacos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Stents , Ticlopidina/efeitos adversos , Ticlopidina/uso terapêutico , Resultado do Tratamento
7.
Int Heart J ; 53(1): 18-22, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22398671

RESUMO

A stress-induced myocardial perfusion abnormality (MPS), in the absence of angiographically significant epicardial coronary artery disease, is considered a "false-positive" test result. We hypothesized that echocardiography would provide complementary prognostic and pathophysiologic data relevant to the management of patients with MPS and normal coronary angiograms. Accordingly, left atrial volume index (LAVi) was assessed by echocardiography in 38 patients with false positive MPS as defined by normal coronary angiograms and 26 patients with true negative MPS from a total of 1,356 patients stressed from July 2006-May 2008. Pathologically abnormal elevation of LAVi (≥ 32 mL/m(2)) was observed in 16 of 19 women (84%) and 11 of 19 men (58%) in the false positive MPS (FPMPS) group while none of the patients in the true negative MPS (TNMPS) group had elevated LAVi. In the FPMPS group mean LAVi was significantly higher in women than men (40.64 ± 11.4 mL/m(2) versus 32.6 ± 10.5 mL/m(2), P = 0.01). The mean LAVi in the FPMPS group was significantly different from the TNMPS group (36.6 ± 11.6 versus 21 ± 7 mL/m(2), P = 0.000). A stepwise logistic regression determined BSA, LAV and LAVi as useful in predicting false positive and true negative MPS. All three were significant predictors (P < 0.01) and the area under the ROC curve was 0.91. Our findings in this relatively small cohort suggest that patients with false positive MPS have a greater increased LAVi.


Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Ecocardiografia , Imagem de Perfusão do Miocárdio , Adulto , Idoso , Estudos de Coortes , Reações Falso-Positivas , Feminino , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade
8.
Vasc Health Risk Manag ; 8: 65-75, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22371653

RESUMO

The substantial reduction in ischemic events provided by the dual antiplatelet regimen with aspirin and clopidogrel is well documented in patients with acute coronary syndrome and patients undergoing percutaneous coronary intervention. Recently the variable response to the antiplatelet agents has received considerable attention after several "boxed warnings" on clopidogrel. This led to intense controversy on pharmacokinetic, pharmacodynamic, and pharmacogenomic issues of antiplatelet drugs, especially clopidogrel. Research use of platelet function testing has been successfully validated in identifying new antiplatelet drugs like prasugrel and ticagrelor. These platelet function assays are no longer regarded just as a laboratory phenomenon but rather as tools that have been shown to predict mortality in several clinical trials. It is believed that suboptimal response to an antiplatelet regimen (pharmacodynamic effect) may be associated with cardiovascular, cerebrovascular, and peripheral arterial events. There has been intense controversy about this variable response of antiplatelet drugs and the role of platelet function testing to guide antiplatelet therapy. While the importance of routine platelet function testing may be uncertain, it may be useful in high-risk patients such as those with diabetes mellitus, diffuse three vessels coronary artery disease, left main stenosis, diffuse atherosclerotic disease, and those with chronic renal failure undergoing percutaneous coronary intervention. It could also be useful in patients with suspected pharmacodynamic interaction with other drugs to assure the adequacy of platelet inhibition. While we wait for definitive trials, a predictive prognostic algorithm is necessary to individualize antiplatelet therapy with P2Y12 inhibitors based on platelet function assays and genetic testing.


Assuntos
Síndrome Coronariana Aguda/tratamento farmacológico , Angioplastia Coronária com Balão , Plaquetas/efeitos dos fármacos , Doença da Artéria Coronariana/terapia , Inibidores da Agregação Plaquetária/uso terapêutico , Testes de Função Plaquetária , Antagonistas do Receptor Purinérgico P2Y/uso terapêutico , Síndrome Coronariana Aguda/sangue , Algoritmos , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/instrumentação , Animais , Doença da Artéria Coronariana/sangue , Técnicas de Apoio para a Decisão , Monitoramento de Medicamentos , Quimioterapia Combinada , Medicina Baseada em Evidências , Humanos , Inibidores da Agregação Plaquetária/efeitos adversos , Inibidores da Agregação Plaquetária/farmacocinética , Valor Preditivo dos Testes , Antagonistas do Receptor Purinérgico P2Y/efeitos adversos , Antagonistas do Receptor Purinérgico P2Y/farmacocinética , Medição de Risco , Fatores de Risco , Stents , Resultado do Tratamento
9.
Am J Cardiol ; 105(3): 362-7, 2010 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-20102949

RESUMO

Intensive lifestyle changes have been shown to regress atherosclerosis, improve cardiovascular risk profiles, and decrease angina pectoris and cardiac events. We evaluated the influence of the Multisite Cardiac Lifestyle Intervention Program, an ongoing health insurance-covered lifestyle intervention conducted at our site, on endothelial function and inflammatory markers of atherosclerosis in this pilot study. Twenty-seven participants with coronary artery disease (CAD) and/or risk factors for CAD (nonsmokers, 14 men; mean age 56 years) were enrolled in the experimental group and asked to make changes in diet (10% calories from fat, plant based), engage in moderate exercise (3 hours/week), and practice stress management (1 hour/day). Twenty historically (age, gender, CAD, and CAD risk factors) matched participants were enrolled in the control group with usual standard of care. At baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD) was performed in the 2 groups. Serum markers of inflammation, endothelial dysfunction, and angiogenesis were performed only in the experimental group. After 12 weeks, FMD had improved in the experimental group from a baseline of 4.23 + or - 0.13 to 4.65 + or - 0.15 mm, whereas in the control group it decreased from 4.62 + or - 0.16 to 4.48 + or - 0.17 mm. Changes were significantly different in favor of the experimental group (p <0.0001). Also, significant decreases occurred in C-reactive protein (from 2.07 + or - 0.57 to 1.6 + or - 0.43 mg/L, p = 0.03) and interleukin-6 (from 2.52 + or - 0.62 to 1.23 + or - 0.3 pg/ml, p = 0.02) after 12 weeks. Significant improvement in FMD, C-reactive protein, and interleukin-6 with intensive lifestyle changes in the experimental group suggests > or = 1 potential mechanism underlying the clinical benefits seen in previous trials.


Assuntos
Aterosclerose/sangue , Aterosclerose/terapia , Proteína C-Reativa/metabolismo , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/prevenção & controle , Endotélio Vascular/metabolismo , Comportamento de Redução do Risco , Angina Pectoris/sangue , Angina Pectoris/prevenção & controle , Biomarcadores/sangue , Artéria Braquial/fisiopatologia , Estudos de Casos e Controles , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Óxido Nítrico Sintase Tipo III/sangue , Projetos Piloto , Qualidade de Vida , Fatores de Risco , Estresse Psicológico/prevenção & controle , Fatores de Tempo , Vasodilatação
10.
Am J Med Genet A ; 152A(1): 191-5, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20034097

RESUMO

We report on a case of a 25-year-old male with 1p36 deletion syndrome, who was diagnosed with left ventricular noncompaction (LVNC). The association of this rare chromosomal abnormality with LVNC is reported in the pediatric literature, but it has not previously been specifically reported in adults. It is important to diagnose this unclassified cardiomyopathy in the adult population with this chromosomal abnormality for appropriate management and treatment as highlighted in our case.


Assuntos
Aberrações Cromossômicas , Cromossomos Humanos Par 1 , Ventrículos do Coração/fisiopatologia , Adulto , Humanos , Masculino
11.
Echocardiography ; 26(7): 865-7, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20003023

RESUMO

Real time two-dimensional transthoracic and transesophageal echocardiography demonstrated a mobile echolucent mass attached to the pulmonary valve in a 25-year-old adult, 20 years following balloon pulmonary valvuloplasty. The mass was surgically excised and pathology showed it to be a cyst.


Assuntos
Cateterismo/efeitos adversos , Cistos/etiologia , Cistos/cirurgia , Ecocardiografia Doppler/métodos , Estenose da Valva Pulmonar/cirurgia , Valva Pulmonar/diagnóstico por imagem , Valva Pulmonar/cirurgia , Adulto , Cistos/diagnóstico por imagem , Humanos , Masculino , Estenose da Valva Pulmonar/complicações , Resultado do Tratamento
12.
Echocardiography ; 26(6): 739-41, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19594823

RESUMO

Percutaneous closure of atrial septal defects (ASD) in adults has emerged as an alternative to surgery. We report a rare complication of an atrial septal occluder device embolization into the pulmonary artery which was detected by fluoroscopy and echocardiography. The potential usefulness of live/real time three-dimensional transthoracic echocardiography in the management of patients undergoing percutaneous ASD occlusion is described.


Assuntos
Ecocardiografia Tridimensional/métodos , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/instrumentação , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/lesões , Adulto , Sistemas Computacionais , Humanos , Masculino
13.
Echocardiography ; 26(5): 598-609, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19438700

RESUMO

This case series demonstrates the incremental value of three-dimensional transthoracic echocardiography (3D TTE) over two-dimensional transthoracic echocardiography (2D TTE) in the assessment of 11 patients with right ventricular (RV) masses or mass-like lesions (three cases of RV thrombus, one myxoma, one fibroma, one lipoma, one chordoma, and one sarcoma and three cases of RV noncompaction, which are considered to be mass-like in nature). 3D TTE was of incremental value in the assessment of these masses in that 3D TTE has the capacity to section the mass and view it from multiple angles, giving the examiner a more comprehensive assessment of the mass. This was particularly helpful in the cases of thrombi, as the presence of echolucencies indicated clot lysis. In addition, certainty in the number of thrombi present was an advantage of 3D TTE. Also, sectioning of cardiac tumors allowed more confidence in narrowing the differential diagnosis of the etiology of the mass. In addition, 3D TTE allowed us to identify precise location of the attachments of the masses as well as to determine whether there were mobile components to the mass. Another noteworthy advantage of 3D TTE was that the volumes of the masses could be calculated. Additionally, the findings by 3D TTE correlated well with pathologic examination of RV tumors, and some of the masses measured larger by 3D TTE than by 2D TTE, which was also validated in one case by surgery. As in the case of RV fibroma, another advantage was that 3D TTE actually identified more masses than 2D TTE. RV noncompaction was also well studied, and the assessment with 3D TTE helped to give a more definitive diagnosis in these patients.


Assuntos
Ecocardiografia Tridimensional/métodos , Neoplasias Cardíacas/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Trombose/diagnóstico por imagem , Disfunção Ventricular Direita/diagnóstico por imagem , Adulto , Sistemas Computacionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
14.
Echocardiography ; 25(10): 1138-44, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18986398

RESUMO

Five adult patients with Takotsubo cardiomyopathy (TC) diagnosed by usual criteria were studied with velocity vector imaging (VVI) on admission and at follow-up, when their LV function had improved, as assessed by 2D TTE wall-motion score (WMS) index. Averaged peak segmental longitudinal strain (S) in systole, and velocity (V) and strain rate (SR) in both systole and diastole were measured from apical 4- (A4C) and 2-chamber views (A2C) in all patients. The data obtained by VVI were analyzed separately for involved and uninvolved segments, which were independently assessed by WMS. In the involved segments, systolic S, V, SR, and diastolic SR improved (P-value < 0.05) on follow-up. Diastolic V showed a trend toward improvement but did not reach statistical significance. In the uninvolved segments, none of the parameters improved significantly either during systole or diastole. In three of these five patients, left atrial (LA) walls were also studied by placing region of interest (ROI) points in the middle of each wall. Peak segmental LA systolic and diastolic V and SR as well as systolic S were obtained for both involved and uninvolved LA walls which were assessed independently using WMS similar to LV. In the involved LA walls, none of the atrial systolic and diastolic parameters changed significantly but all parameters with the exception of systolic V showed a tendency toward improvement during follow-up. Among the uninvolved LA walls, none changed significantly but atrial systolic SR and, diastolic V and SR tended to increase during follow-up. Our retrospective study using VVI demonstrates that TC patients also have LV systolic and diastolic longitudinal dysfunction, not just systolic radial dysfunction as assessed by traditional 2D TTE indices. Longitudinal LA dysfunction may also be present.


Assuntos
Função do Átrio Esquerdo , Velocidade do Fluxo Sanguíneo/fisiologia , Ventrículos do Coração/diagnóstico por imagem , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Ultrassonografia , Idoso , Diástole/fisiologia , Seguimentos , Humanos , Pessoa de Meia-Idade , Sístole/fisiologia , Ultrassonografia/métodos
16.
W V Med J ; 103(3): 10-2, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17849668

RESUMO

A retrospective analysis was conducted of 79 consecutive patients who underwent enhanced external counterpulsation (EECP) at West Virginia University Hospitals during the period of November 1998 to September 2005 to determine its efficacy and safety in treating angina. A chart review and/or phone survey was performed to analyze pertinent clinical data (sublingual nitroglycerin use and angina class) pre and post EECP. A total of 60 (76%) patients who were referred for EECP successfully finished the 35 treatments. Seventy-five percent of the patient population improved at least one angina class after a full course of treatment. Therapy was discontinued due to adverse effects in 12 (15%) patients. Statistically significant improvements in angina class and reduction in anti-angina medications were observed in every co-morbid subgroup analyzed, including patients with peripheral vascular disease, diabetes, hyperlipidemia, hypertension, smoking, Post-MI, and LVEF < 40% (P < .05, Wilcoxon Signed-Rank test). Overall, EECP was effective in improving angina as reflected in a substantial reduction in antiangina medications in 59 (75%) patients.


Assuntos
Angina Pectoris/terapia , Contrapulsação/métodos , Hospitais Universitários , Idoso , Contrapulsação/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , West Virginia
18.
Echocardiography ; 22(2): 137-43, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15693780

RESUMO

This preliminary study demonstrates the superiority of live three-dimensional transthoracic echocardiography (3D TTE) over two-dimensional (2D) TTE in the assessment of left atrial (LA) tumors in four patients studied by us (three myxomas, one hemangioma, all subsequently pathologically proven). Because of the unique ability of live 3D TTE to systematically section and view the contents of an intracardiac mass, LA myxomas in the three patients studied could be more confidently diagnosed by noting isolated echolucent areas consistent with hemorrhage/necrosis in the tumor mass. On the other hand, a definite echolucent area was found by 2D TTE in only two of the three patients with myxoma. In the fourth patient with a hemangioma, live 3D TTE showed much more extensive and closely packed echolucencies with little solid tissue as compared to a myxoma consistent with a highly vascularized tumor. In contrast, 2D TTE demonstrated only two isolated echolucencies in the tumor suggesting an erroneous diagnosis of myxoma.


Assuntos
Ecocardiografia Tridimensional , Ecocardiografia , Neoplasias Cardíacas/diagnóstico por imagem , Feminino , Átrios do Coração , Hemangioma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Mixoma/diagnóstico por imagem
19.
Echocardiography ; 22(1): 43-5, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15660686

RESUMO

We present a patient with aortic arch-left innominate vein (LIV) fistula diagnosed by transesophageal echocardiography. Also, an interrupted linear echo was noted within the dilated LIV with flow signals moving across the area of interruption, suggestive of left innominate vein pseudo-aneurysm or dissection. The patient subsequently underwent successful surgical repair of the fistula.


Assuntos
Aorta Torácica/anormalidades , Fístula Arteriovenosa/diagnóstico por imagem , Veias Braquiocefálicas/anormalidades , Ecocardiografia Transesofagiana/métodos , Adulto , Fístula Arteriovenosa/fisiopatologia , Velocidade do Fluxo Sanguíneo , Diagnóstico Diferencial , Ecocardiografia Doppler em Cores , Humanos , Masculino
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