Twenty-nine patients were studied by pulsed, continuous wave, and color Doppler before and after percutaneous transseptal valvuloplasty. New atrial septal defects were detected in 14 patients, and the patients were monitored for up to 320 days after the procedure. The diameter of the defect, best evaluated by the transesophageal approach, was 3 to 15 mm. A narrow, high velocity (1.4 to 3.1 meters per second) left-to-right shunt jet was detected in 13 of 14 patients. The shunt jet was continuous in nine of 14 patients, late systolic-holodiastolic in four patients, and bidirectional in one patient. Cardiac catheterization in nine patients confirmed the Doppler findings and demonstrated a peak pressure gradient of 10 to 32 mm Hg between the left and right atria. Oximetry revealed a calculated pulmonary to systemic flow ratio ranging from 2.3:1 in the patient with the largest atrial septal defect by echocardiography to 1:1 (no oxygen saturation step-up) in the patient with the smallest atrial septal defect. In the three patients who underwent cardiac surgery, the operative findings confirmed those of echocardiography. We concluded that atrial septal defects are common after transseptal valvuloplasty. Usually, their relatively small size and the underlying valvular disease that produces high left atrial pressure are responsible for the high pressure gradient between the left and right atria. This results in the high velocity and continuous shunt jet detected by Doppler echocardiography.

Adult↗

PubMedDate not supplied

Metastatic cardiac liposarcoma: diagnosis by transesophageal echocardiography and magnetic resonance imaging.

The most superior portion of the right atrium is not well visualized by transthoracic echocardiography. This limits the ability of the technique to detect intracardiac disease in this area. We describe a 41-year-old man with a history of liposarcoma in whom transthoracic echocardiography was unable to elucidate a right atrial metastasis. Transesophageal echocardiography demonstrated the morphology and extent of the large right atrial mass. These findings were well correlated with both magnetic resonance imaging and surgery.

Adult↗

PubMedDate not supplied

Transesophageal echocardiography during percutaneous mitral valvuloplasty.

Transesophageal echocardiography was performed during mitral balloon valvuloplasty. It provided valuable information about the position of the transseptal needle, wires, and balloon catheter throughout the procedure, and it helped in the immediate evaluation of its results. Transesophageal echocardiography was well tolerated and there were no complications.

Catheterization↗

PubMedDate not supplied

The influence of diabetes and hypertension on the results of coronary revascularization.

The effects of diabetes and hypertension on the early postoperative course of patients undergoing coronary revascularization were studied by reviewing the records of 177 patients operated upon in 1972. There were 121 nondiabetic, nonhypertensive; 32 hypertensive; ten diabetic; and 14 diabetic-hypertensive patients. The incidence of postoperative low cardiac output, renal insufficiency and arrhythmia was significantly higher in the hypertensive patient. Operative mortality ranged from 0 in diabetic patients, to 0.8 per cent in nondiabetic, nonhypertensives, to 7.1 per cent in diabetic-hypertensives and 12.5 per cent in hypertensive patients, suggesting an increased risk for the hypertensive patient. The one- to two-year follow-up results documented symptomatic improvement in 90.7 per cent of patients with little adverse effect apparent from diabetes or hypertension. Pre- and postoperative coronary angiography was carried out in 103 patients between 1968 and 1973 with a mean elapsed time between operation and postoperative angiogram of 9.3 months. The progression of atherosclerosis was graded on a 0-4 basis in both grafted and ungrafted coronary arteries. While hypertension appeared to contribute to disease progression, the incidence of vein graft and internal mammary artery bypass occlusion was not significantly affected by either diabetes or hypertension. This study has shown that while hypertension contributes to increased morbidity and mortality in the early postoperative period and an increased rate of progression of atherosclerosis, neither diabetes nor hypertension appeared to influence the one- to two-year results of coronary revascularization.

Acute Kidney Injury↗

PubMedDate not supplied

Isolated diagonal artery disease.

The clinical, electrocardiographic, angiographic, and hemodynamic features of seven patients with isolated, severe (greater than 75% of diameter) narrowing of a diagonal branch of the left anterior descending artery are presented. The incidence of this entity was 0.5% among patients with arteriosclerotic heart disease undergoing coronary angiography. Angina was severe in two patients, moderate in four, and mild in one. One patient had unstable angina. Stress tests were abnormal in two of three patients. Six patients had normal left ventricular angiograms, and one had a mildly decreased ejection fraction. All patients survived a mean follow-up of 18 months (range 6 to 32). No patient suffered a myocardial infarction. Five became asymptomatic on medical therapy; one patient with mild and another with moderate angina were unimproved. This rare anatomic subset of patients with coronary artery disease has a favorable short-term prognosis.

Adult↗

PubMedDate not supplied

Genetic regulation of xanthine dehydrogenase in Drosophila melanogaster.

Explore the source record for details and available documents.

Animals↗

PubMedDate not supplied

Significant reduction of infarct size with left atrial to femoral artery bypass.

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Animals↗

PubMedDate not supplied

Digital range-gated echocardiographic tracking.

Many applications of standard echocardiography require velocity computation which is usually determined by manually measuring slopes on an echocardiogram. However, manual techniques are limited by the inaccuracy with which slopes may be drawn and measured, the large amount of time required for detailed analysis, and the lack of real time information. A system is described which automatically provides real time and continuous and essentially instantaneous position and velocity measurements on selected heart structures. The system is designed with digital electronics wherever possible to facilitate data processing and the transfer of information to a computer. The system has advantages over continuous wave ultrasonic Doppler techniques and a range-gated ultrasonic Doppler system because dynamic, range-gated digital tracking allows target isolation and identification. Also, because range gate size may be kept small, noise susceptibility is minimized.

Computers↗