We describe the ultrasound appearance of postnatal development of an angiographically proven coarctation of the aorta in a full-term infant. The diagnosis of a discrete coarctation was subsequently supported on a repeat two-dimensional echocardiogram, after an initial clinical and two-dimensional study at 6 h of age that had revealed only minimal juxtaductal aortic deformity. We stress the importance of two-dimensional echocardiography as a reliable noninvasive method for detecting the change in aortic contour occurring with ductal closure in infants with predisposing aortic anatomy who will go on to develop coarctation of the aorta.

Aortic Coarctation↗

PubMedDate not supplied

Effects of doxorubicin on diastolic function, contractile reserve, and ventricular-vascular coupling in piglets.

The use of doxorubicin as an anticancer drug is limited by its cardiac toxicity. To examine the adverse effects of doxorubicin on cardiac function and ventricular-vascular coupling in piglets, eight piglets received five doses of intravenous doxorubicin, 1.5 mg/kg/dose, every 4-7 days starting at 3 weeks of age. A control group consisted of eight normal piglets. Using conductance and manometric catheters, indices of cardiac function, including end systolic elastance (Ees), preload-recruitable stroke work, dP/dtmax, tau, dP/dtmin, dV/dtmax, and end systolic stiffness, were calculated from volume and pressure measurements at rest and during infusion of isoproterenol. Ventricular-vascular coupling was examined by measuring arterial elastance (Ea) and Ea/Ees. Significant differences in relaxation were found between groups. Indices of diastolic stiffness and of contractile function were not different between groups. Baseline contractile efficiency was increased in the doxorubicin group. Ea and Ea/Ees were lower in the doxorubicin group. Ea/Ees was near 1 at baseline in the doxorubicin group, indicating that conditions were optimized for performance of external stroke work. Therefore, the reserve to increase external cardiac work was diminished. The finding of altered diastolic function suggests the importance of screening of diastolic indices to detect the earliest disturbances in cardiac function caused by doxorubicin.

Animals↗

PubMedDate not supplied

Case studies of cycle exercise early after cardiothoracic surgery.

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Adolescent↗

PubMedDate not supplied

Quantitative digital angiography as an adjunct to the intraoperative placement of endovascular stents in congenital heart disease.

Clearly identifiable intraoperative landmarks render the placement of intraoperative stents difficult. Preoperative use of quantitative digital angiography helps the surgeon accurately insert endovascular stents intraoperatively. By using defined points of reference, we were able to carefully select the size and lengths of stents before the operation and precisely place these stents in the operating room. Furthermore, we have been able to redilate these stents using the same techniques at subsequent operations. Our results reflect the efficacy of this technique.

Angiography, Digital Subtraction↗

PubMedDate not supplied

[Clinical applications of Doppler echocardiography].

In this review, we demonstrate the normal patterns of flow and some quantitative applications of Doppler echocardiography combined with two-dimensional imaging. Flow information can be accurately measured and valve gradient calculations can be made in patients with stenotic diseases. Further corroborative work in this area is necessary before definitive statements can be made, but this appears to be a promising noninvasive technique which can be applied at the bedside or in an ambulatory setting with a fair degree of confidence.

Atrial Function↗

PubMedDate not supplied

[Two-dimensional echocardiography in the study of aneurysms of the membranous interventricular septum].

Seven patients with angiographically proven aneurysm of the membranous interventricular septum associated with membranous ventricular septal defect were studied by two-dimensional echocardiography. In all patients a curvilinear, dome-shaped echo arising from the upper ventricular septum and bulging toward the right ventricular cavity in systole was identified. This finding was detected in all long axis views (7/7), and 4/7 short axis views, in 4/6 apex four chamber views and in 3/6 subcostal four chamber views. Two-dimensional echocardiographic studies in forty patients with angiographically proven membranous ventricular septal defect, but not septal aneurysm, revealed only one case with similar findings, suggesting ventricular septal aneurysm, in the long axis and apex four chamber views. We conclude that two-dimensional echocardiographic imaging of a curvilinear echo in the proximal interventricular septum, bulging toward the right ventricle in systole and visualized in different planes, is very suggestive of aneurysm of the membranous ventricular septum. Two-dimensional echocardiography appears to have acceptable specificity for the diagnosis of aneurysms of the ventricular septum.

Child↗