PubMed · 15975340
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Richard Mainwaring. 2005. Invited commentary.. https://doi.org/10.1016/j.athoracsur.2005.03.129
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Percutaneous transvenous mitral commissurotomy (PTMC) is an effective treatment for mitral stenosis, but trans-septal puncture carries a certain risk of complications. There have been few reports on phase-array intra-cardiac echocardiography (ICE) guidance in trans-septal puncture for PTMC, especially in patients with dilated left atrium or distorted anatomy. Herein, we report our preliminary experience with ICE-guided trans-septal puncture in patients with dilated left atrium (>or=5.5 cm) who underwent PTMC. From June 2005 to March 2006, there were nine consecutive patients with symptomatic mitral stenosis and left atrium size larger than 5.5 cm who underwent trans-septal puncture for PTMC with the ICE guidance in this institution by a same operator. The procedural and catheterization results were analyzed. Using ICE guidance, the success rate for trans-septal puncture was 100% for all patients with dilated left atrium (>or=5.5 cm). The trans-septal procedures were free of major and minor complications and the patients were not exposed to contrast medium. Mitral valve area increased significantly from 1.0+/-0.2 cm(2) to 1.9+/-0.2 cm(2). Our preliminary result showed that ICE safely and effectively guided trans-septal puncture for PTMC in patients with dilated left atrium (>or=5.5 cm), thus eliminating contrast medium usage and avoiding unnecessary longer X-ray exposure.
A 15-month-old boy with atrial fibrillation was found to have gross cardiomegaly on a chest radiography; further evaluation by echocardiography showed a giant right atrial aneurysm which is in the form of a cyst like lesion. The patient underwent successful surgical reduction of the right atrium converting his heart rhythm to normal. The operative measure was taken to prevent thrombus formation in the right atrium and lower the risk of atrial arrhythmias. The morphologic features of the resected atrial tissue showed a thin wall with a central aneurysm and focal endocardial fibrosis without inflammatory response consistent with a diagnosis of idiopathic dilatation of the right atrium.
We report a case of air embolism detected by transesophageal echocardiography in a patient undergoing open heart surgery for acute mitral regurgitation. Intraoperative transesophageal echocardiography revealed an increased brightness of the apical wall and a severely compromised left ventricular myocardium with severe diffuse hypokinesis after removal of the aortic cross clamps and spontaneous resolution in the control echocardiography.