Recent developments in echocardiographic imaging.

PURPOSE OF REVIEW: This review provides an outline of recent applications related to the use of ultrasonography in various catheter-based procedures for the repair of many valvular abnormalities. RECENT FINDINGS: Percutaneous interventions are becoming a safe and effective therapeutic modality in the management of various valvular defects. The intrinsic ability of ultrasound to provide real-time accurate assessment of cardiac and valvular structural and functional abnormalities makes this modality distinctively useful in the execution of percutaneous valvular procedures and evaluation of their results.Clinical applications of myocardial deformation and cardiac mechanics have been investigated in an increasing number of clinical applications. Speckle tracking accurately measures myocardial deformation parameters and has been recently applied to the evaluation of mitral insufficiency mechanisms. SUMMARY: Recent developments in echocardiography are promoting this modality from its traditional role of diagnostic technique into one suitable for aiding in the execution of complex catheter-based procedures and for accurate monitoring of therapeutic response in many clinical settings.

A rare case of isolated congenital right ventricular inflow obstruction due to the presence of an intraventricular muscular shelf.

A 56-year-old man presented with anasarca and a 40-lb weight gain that had occurred over the course of 3 to 4 weeks. He had a history of permanent atrial fibrillation and a congenital anomaly of the right ventricular inflow tract. This defect consisted of a muscular shelf in the right ventricular inflow tract, which encased the tricuspid subvalvular apparatus in such a manner that it created tricuspid stenosis. The clinical consequences of this anatomic and hemodynamic situation were a massively dilated right atrium, permanent atrial fibrillation, and clinical evidence of right-sided heart failure, including fluid retention and ascites. The patient underwent surgical resection of the muscular shelf, which was followed by progressive resolution of the ascites and fluid retention.