Search PubMed⌕ Search

Biomedical subjects

R Gramiak

Publications and source records attributed to R Gramiak.

At least 37 records · Page 2Linked to original sources
PubMed1978

Bilateral atrial myxomas. Echocardiographic considerations.

In this report we describe a patient with bilateral atrial myxomas, which were diagnosed preoperatively by echocardiography and angiography, and successfully removed. The excised tumor mass consisted of mobile right and left atrial myxomas connected by a common stalk which passed through the atrial septum, collectively resembling the shape of a dumbbell. Preoperative echocardiographic and angiographic observations were instrumental in planning the surgical approach, and correlated well with intraoperative findings and with the anatomic configuration of the intact pathologic specimen. Diagnostic aspects of echocardiography are emphasized as they relate to both isolated and bilaterally-occurring atrial myxomas.

Adult↗
PubMed1978

The relationship between aortic valve closure and aortic root motion.

The minimum interval between aortic valve closure and the onset of posterior motion of the posterior aortic wall (C--PW) was obtained from M-mode echographic studies in normal subjects and patients with mitral regurgitation (MR), rheumatic mitral stenosis (MS), mixed rheumatic MS and MR, pure aortic stenosis (AS), and pure aortic insufficiency. Three-fourths of the patients with MR and 2/3 of those with AS had short C--PW intervals. Short C--PW intervals are probably the result of early mitral valve opening with rapid LA emptying, whereas slow emptying due to dilated, relatively inert left atria may account for normal C--PW intervals in patients with MR. C--PW intervals are affected by both ventricular ejection and LA dynamics and may prove useful in evaluating suspected mitral or aortic valve disease.

Adolescent↗
PubMed1977

The reliability of echocardiography in the diagnosis of infective endocarditis.

The echocardiograms of 17 patients with proved infective endocarditis were surveyed to assess the reliability of echocardiography in this disease. Vegetations were present on 20 valves (11 aortic, 7 mitral, 2 tricuspid) at surgery or autopsy. Echocardiography correctly identified the abnormality in 11 valves. There were 8 valves with false-negative studies of which only one examination was technically inadequate. One false-positive echocardiogram was found. A negative echocardiogram does not exclude infective endocarditis. The size of the vegetation is not the only consideration in its detection echocardiographically. False-positive and false negative studies are discussed.

Adolescent↗
PubMed1977

Echocardiographic features of combined membranous subaortic stenosis and acquired calcific aortic valvulopathy.

The M-mode echocardiographic features of aortic valve structure and motion in a 45-year-old male with combined congenital subaortic diaphragm and acquired deformity of the aortic valve are described. Clinical, hemodynamic, and angiographic studies suggested calcific aortic valve disease with stenosis and insufficiency, but the additional presence of a subaortic diaphragm was not appreciated. Cardiac ultrasonography demonstrated multiple, central diastolic aortic valve cusp echoes consistent with a thickened, calcified, tricuspid aortic valve. Despite calcification of the cusps, however, enough systolic cusp excursion remained to demonstrate an early systolic, rapid movement toward closure of the right coronary cusp-a finding suggestive of fixed subvalvular obstruction. Surgery confirmed a discrete subaortic diaphragm and a tricuspid, thichened, mildly calcified aortic valve with fusion of the cusp commissures at their origins and rolling back of the cusp edges. The value of echocardiography in the evaluation of the left ventricular outflow tract and aortic valve is emphasized.

Aortic Valve↗
PubMed1976

Echocardiographic study of the effects of acute left atrial hypertension on left atrial size.

This study was designed to investigate the effects of acute left atrial hypertension on left atrial size. Twenty-four patients with acute myocardial infarction were studied. The estimated mean left atrial pressure (LAm) was correlated with left atrial (LA) size obtained by echocardiogrphy. The LAm was elevated (greater than 12 mmHg) in 15 patients (Group I). The LA size was within normal limits in all but two patients who had minor increases. The LAm was normal in nine patients (Group II). The LA size was normal in each case. The LA size remained unchanged in those patients who had a stable LAm. We conclude that acute increases in LAm are not usually associated with LA enlargement beyond the upper limit of the normal range.

Blood Pressure↗
PubMed1976

Echocardiographic studies of abnormalities associated with coarctation of the aorta.

Echocardiograms were performed in thirty-six patients (aged 4 to 36 years) with proven coarctation of the aorta. Nineteen patients (53%) were found to have marked diastolic eccentricities of their aortic valves (Eccentricity Index greater 1.5), indicating the presence of bicuspid aortic valves. One of these patients also had multilayered aortic root echoes in diastole. Five patients had angiographic proof of their aortic valve morphologies which corroborated the echo findings. Five patients with bicuspid aortic valves showed mitral valve diastolic flutter indicative of aortic regurgitation. Idiopathic hypertrophic subaortic stenosis (IHSS) was suspected in four patients (11%) with abnormal systolic anterior motion of the mitral valve; three of these patients also had asymmetric septal hypertrophy. There was catheterization proof of IHSS in one patient. Two patients (5.6%) demonstrated mitral valve proplapse.

Amyl Nitrite↗
PubMed1976

Echocardiography of cardiac valves in pericardial effusion.

Nine adult patients with large pericardial effusions (PE) demonstrated echocardiographic motion abnormalites of cardiac valves in systole. In four cases (Group 1), the abnormal findings consisted of prominent systolic anterior movements of the mitral valve resembling those seen in idiopathic hypertrophic subaortic stenosis. In Group 2(five cases), typical mitral valve prolapse patterns with large posterior midsystolic displacements well below the C point were observed. Additional abnormalities in Group 2 included tricuspid valve prolapse patterns (four cases), early systolic movement of the aortic valve toward closure (three cases), midsystolic notching of the pulmonary valve (two cases) and abnormal or attenuated motion of the aortic root in all patients. Marked decrease or resolution of PE resulted in complete disappearance of all the observed abnormalities. These findings appeared to be related to large fluid collections behind the left atrium and abnormal movement of the heart in the pericardial space. In the presence of PE, therefore, the echocardiographic observation of abnormal valve motion may not be clinically significant.

Adult↗
PubMed1976

Cardiac reconstruction imaging in relation to other ultrasound systems and computed tomography.

A computer-controlled system is described for the generation of two-dimensional motion images of the heart. A standard B scanner is used to scan the area of interest during 40-50 cardiac cycles, and the computer controls recording of the ultrasound signals, beam position indicators, and physiologic data. The ultrasonic echoes are reformatted by the computer into sequential frames by reference to the ECG. Images are displayed in motion on a large monitor, and hard copy is obtained on 35 mm cine film. Off-line computer-controlled signal processing is utilized for image enhancement of clinical studies. Real-time systems for the production of two-dimensional motion images of the heart are discussed and compared to computer reconstruction of ultrasound cardiac imaging. The advantages of ultrasound imaging of the heart and other body areas are presented, and prospectives are offered by which the present and future roles of ultrasound can be evaluated in respect and future roles of ultrasound can be evaluated in respect to computed tomography. It is concluded that ultrasound will remain the primary noninvasive modality for cardiac motion study and that ultrasound will continue to provide important clinical information in all parts of the body where it is currently employed.

Computers↗
PubMed1975

Report of the inter-Society Commission for Heart Disease Resources. Optimal resources for ultrasonic examination of the heart.

The echocardiographic examination is described and the current status of ultrasound in cardiac diagnosis is summarized. Planning guidelines are provided for hospital based echocardiography laboratories including resource criteria for professional personnel and training, equipment, space, and support systems. Minimal case loads for maintaining quality performance of the examiner are recommended and various administrative patterns for organizing an echocardiography service are discussed. Approaches for establishing professional fees and emerging applications of diagnostic ultrasound in cardiovascular medicine are briefly reviewed. There is a description of the procedure for conducting an adequate echocardiographic examination in children and adults.

Adult↗
PubMed1975

Diagnostic ultrasound exposure in man.

In his review of the AAPM statement on ultrasound, the author feels that allowing "some" research or demonstration on normal persons in the face of cautionary statements on as yet unknown side effects is an inconsistent position. The use of videotapes and the development of simulators hacked by data banks are offered in place of tissue phantoms.

Environmental Exposure↗
PubMed1975

Mitral commisurotomy versus replacement. Preoperative evaluation by echocardiography.

Echocardiographic studies of the mitral valve were performed in 57 patients with pure or predominant mitral stenosis who subsequently underwent surgery (30 commissurotomy, 27 valve replacement). Mitral valve calcification was graded heavy (thick, conglomerate echoes), light (multiple, discrete linear echoes) or none (thin, single or duplicate signals). Valve mobility, measured as the excursion from the systolic closed position to the fully opened position in diastole, was classified as normal (20 mm or over), restricted (16-19 mm) or poor (15 mm or less). Absence of mitral valve caclification was the most useful echocardiographic indicator for commissurotomy (18 of )9 cases. The most reliable criteria for valve replacement were heavy valve calcification (11 of 11 cases) and poor cusp mobility (11 of 11 cases). The poor mobility group included 3 patients with heavily calcified valves. Thus 37 of 57 cases (65%) could be reliably categorized regarding the type of surgery performed using these three parameters. The remaining echocardiographic parameters (normal mobility, restricted mobility and light calcification) were less valuable in the assignment of the operative category. Echocardiographic assessment of mitral valve calcification and mobility appears to be of value in planning the surgical approach in patients with pure or predominant mitral stenosis.

Adult↗
PubMed1975

Echocardiography of the tricuspid valve in congenital left ventricular-riht atrial communication.

Two patients, ages 14 and 18, with congenital left ventricular-right atrial communication through a defect in the tricuspid valve were studied by echocardiography. Proof was obtained by angiocardiography and surgery in one and ultrasonic contrast injection and angiocardiography in the other. Both presented clinically as uncomplicated ventricular septal defects. Echocardiography consistently demonstrated a high frequency, low amplitude flutter of the tricuspid valve in systole and none in diastole. Following surgical correction of the defect in one patient, there was complete disappearance of the systolic flutter. Systolic flutter has not been observed with tricuspid incompetence nor with other forms of ventricular septal defects. Fistulous communication from the aorta to the right atrium just above the tricuspid valve did not demonstrate systolic flutter in one patient studies. Tricuspid valve systolic flutter appears to be caused by the passage of the left ventricular jet blood into the right atrium through a defect in the tricuspid valve. Echocardiographic study of the tricuspid valve is of value in the recognition of the congenital left ventricular-right atrial communication.

Adolescent↗
PubMed1975

Echocardiographic features of subpulmonic obstruction in dextro-transposition of the great vessels.

Eleven patients with dextro-transposition of the great vessels (TGV) and subpulmonic (left ventriclar outflow) obstruction documented by cardiac catheterization and angiography were studied by echocardiography. Echocardiographic features were which characterized the outflow obstruction included a) prolonged diastolic apposition of the mitral valve with the ventricular septum (10 patients), b) smaller width of the pulmonary artery as compared to the aortic root (10 cases), and c) narrowing of the subpulmonic area demonstrated by beam anglation studies through the planes of the mitral valve and the pulmonary artery (five cases). In addition, four patients showed abnormal systolic anterior movements (SAMs) of the anterior mitral leaflet resembling those observed in idiopathic hypertrophic subaortic stenosis. The SAM'S WERE LARGE IN THREE PATIENTS AND MAY HAVE ACCENTUATED THE OUTFLOW OBSTRUCTION. Additional evidence for this was provided by the movement of the pulmonary valve towards closure with the onset of the mitral SAM'S. These features were uncommon or absent in a comparison group of 17 patients with TGV and no outflow obstruction. Echocardiography appears to be useful in the diagnosis of subpulmonic muscular obstruction in TGV. Demonstration of definite mitral SAM'S IN SOME PATIENTS SUGGEST THE PRESSENCE OF ASSOCIATED FUNCTIONAL OBSTRUCTION OF THE TYPE SEEN IN IDIOPATHIC HYPERTROPHIC SUBAORTIC STENOSIS.

Adolescent↗