PubMed · 2105112
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
I A Simpson, A J Camm. 1990-01-06. Colour Doppler flow mapping.. https://doi.org/10.1136/bmj.300.6716.1
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
OBJECTIVE: The intermediate results achieved with a new technique for primary repair of tetralogy of Fallot with absent pulmonary valve syndrome are reported. METHOD: Apart from correction of tetralogy of Fallot, this approach includes translocation of the pulmonary artery anterior to the aorta and away from the tracheobronchial tree. Since November 1998 this technique has been employed in three symptomatic newborns and three infants with a diagnosis of tetralogy of Fallot with absent pulmonary valve. The median age at surgery was 37 days (range 14-256 days). The median weight at operation was 3.4 kg (range 2.9-4 kg). All patients had severe respiratory problems and congestive heart failure with cyanosis. RESULTS: There was no early or late death during the follow-up (median 27 months). One patient required redo due to failure to thrive as a consequence of right ventricle volume overload. Valved conduit was inserted to pulmonary position. Respiratory symptoms disappeared or were significantly reduced in all patients. Postoperative computed tomographic scan showed no compression of trachea and main bronchi, pulmonary artery was away from tracheobronchial tree in all patients. Patients are doing well with adequate growth. CONCLUSIONS: The new technique described here has a potential to reduce or eliminate bronchial compression by pulmonary artery. Translocation of pulmonary artery anterior to the aorta takes the dilated pulmonary artery away from the trachea and bronchial tree. This approach was found to be technically feasible and can be useful especially in symptomatic newborns and infants.
Significant mitral regurgitation (MR) may result from primary valve dysfunction or develop secondary to ischemic or dilated cardiomyopathy. The index 'isovolumic contraction time and isovolumic relaxation time divided by ejection time' (ICT + IRT/ET, 'Tei-index') is a well established measure of global cardiac function in patients with dilated cardiomyopathy and cardiac amyloidosis. We sought to define the diagnostic value of the Tei-index in patients with significant MR of various origin. Sixteen asymptomatic control subjects (8 male (m)/8 female (f), age 62+/-8 years, control group), 12 patients with primary MR (PMR) (mean grade 3.1+/-0.3, due to rupture of the chordae tendineae (n = 2), flail leaflet (n = 1), valve prolapse (n = 6) or rheumatic degeneration (n = 3), 6 m/6 f, age 58+/-18 years, NYHA class 2.5+/-0.3, PMR group) and 25 patients with secondary MR (SMR) (mean grade 3.1+/-0.3; due to ischemic (n = 14) or dilated cardiomyopathy (n = 10), 19 m/6 f, age 60+/-11 years, NYHA class 3.1+/-0.5, SMR group) underwent conventional two-dimensional (2D) and Doppler echocardiographic examination including measurement of the Tei-index. In the SMR group, left ventricular ejection fraction was reduced compared to the control and the PMR group (29+/-13% vs. 59+/-8% and 59+/-8%, p < 0.001 for both comparisons). The E/A ratio was elevated in PMR and SMR groups in comparison to the control group (1.74+/-0.44 and 1.70+/-0.45 vs. 1.09+/-0.28, p < 0.05). The Tei-index was easily and reproducibly measured in all study subjects. The mean value of the index was significantly elevated in the SMR group compared to control and PMR groups (0.87+/-0.3 vs. 0.42+/-0.07 and 0.38+/-0.05, p < 0.001). The difference between the control group and the PMR group did not reach statistical significance. In MR patients, receiver operating characteristic curve analysis for the Tei-index yielded an area under the curve of 0.96+/-0.03 for separating the PMR and the SMR group. Using a Tei-index > 0.51 as a cutpoint, SMR was identified with a sensitivity of 92% and a specificity of 88%. In MR patients, a significant correlation between left ventricular end-systolic volume and the Tei-index was observed (r = 0.71, p < 0.01). The Tei-index is a feasible and sensitive indicator of overall cardiac dysfunction in severely symptomatic patients with significant MR secondary to ischemic or dilated cardiomyopathy. The index is in the normal range in symptomatic patients with PMR and preserved systolic function. The Tei-index differentiates between patients with SMR and PMR and may be useful in the work-up of such patients.
A 49-year-old woman with mitral and tricuspid mechanical valve prostheses developed marked weight gain with increasing abdominal girth and facial plethora 4 weeks after anticoagulation was temporarily interrupted for abdominal surgery. Transthoracic and transesophageal echocardiography documented severe tricuspid stenosis and regurgitation. The two discs of the tricuspid prosthesis were immobilized, half open and half closed. The prosthesis was replaced and the patient did well.