0000000000653332

AUTHOR

G. Schreiner

Coarctation of the Aorta: Quantitative Analysis by Transesophageal Echocardiography

Summary Transesophageal echocardiography and standard two-dimensional echocardiography were performed in 15 patients with suspected coarctation of the aorta. Aortic diameters and crosssectional areas were determined by means of TEE and compared with clinical findings and catheterization data. The isthmus of the aorta could be imaged in all patients using TEE, but in only seven patients using standard suprasternal echocardiography. Compared with controls, aortic diameters were narrowed in 9 of 15 patients, and cross-sectional areas were reduced in 13 of 15. There was a satisfactory correlation between TEE data and angiographic and hemodynamic data. TEE is a promising method of a diagnosing a…

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Reliability and Accuracy of Echocardiography for Follow-up Studies after Intervention

By two-dimensional echocardiography limitations of M-mode echocardiography have been eliminated. As a direct and noninvasive method two-dimensional echocardiography seems to be an ideal method for analysis of left ventricular function in follow-up studies. In relation to other methods there are no limitations concerning x-ray exposure, physicians and patients safety. Before different studies can be discussed, reliability and accuracy of two-dimensional echocardiography have to be evaluated. Beat-to-beat, day-to-day, intra- and interobserver variability will be discussed, followed by description of follow-up studies after intervention.

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Coronary Spasm in Patients Treated by Percutaneous Transluminal Coronary Angioplasty

The appearance of coronary spasm during PTCA was analyzed in 140 consecutive patients with stable and unstable angina. Coronary spasm was found in 27 patients (19%) and was more common in unstable than in stable angina pectoris (22 versus 5 patients). While coronary spasm could be seen in the first coronary angiogram in 5/27 patients, it developed during the diagnostic procedure in 6/27 patients. In 16/27 patients coronary spasm was induced by the balloon or the guide wire itself.

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Recanalization of Totally Occluded Coronary Vessels by Percutaneous Transluminal Coronary Angioplasty

Since its introduction in 1977, percutaneous transluminal coronary angioplasty (PTCA) has become an effective approach for treatment of patients with single-vessel disease [1–3, 5]. Treatment of double- and multiple-vessel disease has also been attempted [5, 6]. In patients with angina pectoris total occlusion of coronary vessels is found, and PTCA has also been used in an attempt to restore coronary blood flow in such patients [8, 10]. Even main stem occlusions have been recanalized [11]. In patients with total occlusion of coronary vessels, collateral flow is sufficient to maintain cardiac function at rest but not during exercise [12–14]. Therefore, PTCA seems to be an ideal method for re…

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Detection of spontaneous echocardiographic contrast within the left atrium by transesophageal echocardiography: spontaneous echocardiographic contrast

Transesophageal echocardiography was performed in 314 patients over a period of 24 months using a 3.5 MHz phased-array system fitted to the distal end of a conventional 12 mm endoscope. In 12 patients (2.6%) transesophageal echocardiography could not be performed because of adverse reaction to the gastroscopic procedure. Side effects were a transient A-V block in one patient and asthmatic attack in another. Mitral valve lesions were found in 99 of 314 patients. In 9 of these 99 patients (11%), including 1 patient with mitral valve stenosis and sinus rhythm, 2 with atrial fibrillation, 3 with disc, and 3 with porcine mitral prosthesis, spontaneous echocardiographic contrast was found within …

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