Asunto(s)
Ecocardiografía , Enfermedades de las Válvulas Cardíacas , Adulto , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Enfermedades de las Válvulas Cardíacas/diagnóstico por imagen , Enfermedades de las Válvulas Cardíacas/mortalidad , Enfermedades de las Válvulas Cardíacas/cirugía , Humanos , Masculino , Persona de Mediana Edad , Tasa de Supervivencia , Factores de TiempoRESUMEN
Unicuspid aortic valve (UAV) is a rare malformation that is often difficult to distinguish from a bicuspid aortic valve (BAV) with commissural fusion by echocardiography or intraoperative surgical inspection. This study assessed the accuracy of intraoperative surgical inspection and two-dimensional echocardiography in diagnosing UAV compared to a gold standard of pathological diagnosis. The Mayo Clinic echocardiographic database, tissue registry database and electronic medical record were searched for all patients assigned a diagnosis of UAV by any technique. Transthoracic (TTE), transesophageal (TEE) echocardiographic, and surgical diagnoses were compared to pathological diagnosis as the standard. A clinical diagnosis of UAV was applied to 380 patients by 1 or more method and in 196 (52%) a pathologic evaluation was available to compare to the clinical description given by TTE, TEE, or surgical inspection. Of these 196 patients, only 58 (30%) had a pathological diagnosis of UAV; the majority were found to be BAVs by pathologic evaluation (nâ¯=â¯132, 67%). For diagnosing UAV, the sensitivity and specificity were 15% and 87% for TTE, 28%, and 82% for TEE, and 52% and 51% for surgical inspection, respectively. Valves with bicuspid morphology and extensive commissural fusion were frequently misclassified as UAV by all methods. In conclusion, intraoperative surgical inspection and echocardiography have limitations for diagnosing UAV due to difficulties in accurately assigning a correct morphological diagnosis, which suggests that the current understanding of the natural history of UAV may be inaccurate.
Asunto(s)
Válvula Aórtica/diagnóstico por imagen , Procedimientos Quirúrgicos Cardíacos/métodos , Ecocardiografía Transesofágica/métodos , Enfermedades de las Válvulas Cardíacas/diagnóstico , Adulto , Válvula Aórtica/anomalías , Válvula Aórtica/cirugía , Femenino , Estudios de Seguimiento , Enfermedades de las Válvulas Cardíacas/cirugía , Humanos , Periodo Intraoperatorio , Masculino , Reproducibilidad de los Resultados , Estudios RetrospectivosAsunto(s)
Pericarditis/diagnóstico , Enfermedad Aguda , Antiinflamatorios no Esteroideos/uso terapéutico , Aspirina/uso terapéutico , Técnicas de Imagen Cardíaca , Dolor en el Pecho/etiología , Colchicina/uso terapéutico , Diagnóstico Diferencial , Quimioterapia Combinada , Electrocardiografía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pericarditis/tratamiento farmacológico , Pericarditis/etiologíaRESUMEN
Imaging series highlighting echocardiographic findings associated with the retroaortic anomalous coronary sign and its utility as a non-invasive modality to recognize technically complex and high-risk retroaortic coronary anomalies prior to intervention.
Asunto(s)
Anomalías de los Vasos Coronarios/diagnóstico , Vasos Coronarios/diagnóstico por imagen , Ecocardiografía/métodos , Intervención Coronaria Percutánea , Cuidados Preoperatorios/métodos , Infarto del Miocardio con Elevación del ST/cirugía , Angiografía Coronaria , Anomalías de los Vasos Coronarios/complicaciones , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio con Elevación del ST/complicaciones , Infarto del Miocardio con Elevación del ST/diagnósticoRESUMEN
Coronary artery anomalies are relatively rare (approximately 1% on CTA). We present two exceedingly rare cases, as well as the first reported case of anomalous retro-aortic coronary arteries diagnosed with cardiac CTA and angiography.
