Transcatheter embolization of hepatic arteriovenous fistula in Osler-Weber-Rendu disease--a case report.

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) is associated with arteriovenous fistulas throughout the body that can cause hemodynamic abnormalities. Owing to their size and extent, surgical repair is often not feasible. A patient referred for presumed valvular heart disease is described. On the basis of oximetry data at cardiac catheterization, a large intrahepatic arteriovenous fistula was discovered by aortography. This finding and a history of recurrent epistaxis were consistent with Osler-Weber-Rendu disease. Owing to the size of the fistula, embolization of the right hepatic artery with Gianturco coils was chosen as treatment, with resultant symptomatic improvement and decreased arteriovenous shunting.

New method: calculation of magnification factor from an intracardiac marker.

In order to calculate a magnification factor (MF), an intracardiac marker (pigtail catheter with markers) was evaluated using a new formula and correlated with the conventional grid method. By applying the Pythagorean theorem and trigonometry, a new formula was developed, which is (formula; see text) In an experimental study, MF by the intracardiac markers was 0.71 +/- 0.15 (M +/- SD) and one by the grid method was 0.72 +/- 0.15, with a correlation coefficient of 0.96. In patients study, MF by the intracardiac markers was 0.77 +/- 0.06 and one by the grid method was 0.77 +/- 0.05. We conclude that this new method is simple and the results were comparable to the conventional grid method at mid-chest level.

Giant Lambl's excrescences of papillary muscle and aortic valve: echocardiographic, angiographic, and pathologic findings.

A 54-year-old female with rheumatic heart disease was found to have a mass in the left ventricle by echocardiography and angiography. Subsequently, giant Lambl's excrescences of papillary muscle and aortic valve were confirmed by operation and pathologic examination. Possible complication from cardiac catheterization could be avoided by the utilization of echocardiography prior to catheterization.

Fungal endocarditis complicated by mycotic aneurysm of sinus of Valsalva, interventricular septal abscess, and infectious pericarditis: unique M-mode and two-dimensional echocardiographic findings.

A 26-year-old male with fungal aortic endocarditis is presented in whom unique M-mode and two-dimensional echocardiographic findings permitted a diagnosis of mycotic aneurysm of right sinus of Valsalva and ventricular septal abscess preoperatively. The aneurysm was excised, and the affected aortic and tricuspid valves were replaced with valve prostheses.