ABSTRACT
Previous parallel echocardiographic-angiocardiographic studies have proven specificity and sensitivity of ultrasonography in diagnosing prolapse of the mitral valve. Echocardiograms and phonocardiograms from 68 patients with mitral valve prolapse were studied. Echocardiograms suggestive of mitral valve prolapse were obtained in 66 patients. The typical abnormality consisted of an abrupt posterior displacement of the mitral valve leaflets, either late systolic or pansystolic. Moreover a new pattern not previously described was observed, i.e. an abrupt isolated early systolic posterior motion of the mitral leaflets ("early prolapse"). Phonocardiography, on the other hand, showed a variable spectrum of acoustic findings: non-ejection systolic click and/or late systolic murmur, pansytolic murmur, early systolic click,ejectioarly systolic click, ejection murmur, in variable association, and finally no abnormal sound at all ("silent prolapse"). The authors conclude that mitral valve prolapse may be suspected, whatever the auscultatory finding. Echocardiography provides a useful, non invasive method for detecting those forms which also present an uncommon auscultatory pattern.
Subject(s)
Heart Auscultation , Heart Murmurs , Heart Sounds , Mitral Valve Insufficiency/diagnosis , Mitral Valve/physiopathology , Adolescent , Adult , Aged , Child , Child, Preschool , Echocardiography , Female , Humans , Infant , Male , Middle Aged , Mitral Valve Insufficiency/physiopathology , PhonocardiographyABSTRACT
In seven consecutive cases of transposition of the great arteries balloon atrial septostomy was performed under the sole echocardiographic guidance. The catheter, introduced into either the saphenous, femoral or umbilical vein, was advanced into the inferior vena cava, then into the right atrium, and, through the patent foramen ovale, into the left atrium. The correct location of the tip of the catheter within the left atrial body was easily identified by two-dimensional echocardiography, with a four chamber view from the subcostal approach. Under echocardiographic control alone the inflated balloon was then suddenly withdrawn into the right atrium according to the Rashkind's technique. The procedure was repeated 3 to 5 times. The balloon was inflated with 2 to 3.5 ml of saline solution. The septostomy was deemed to be adequate when the echocardiographic images revealed an atrial septal defect at least 5 mm in size and an increased flapping motion of the inferior rim of the atrial septum. With this technique the risks of complications due to an incorrect location of the catheter are minimized and the outcome of the procedure can be immediately evaluated by measuring the size of the atrial septal defect.
Subject(s)
Cardiac Catheterization/methods , Echocardiography , Transposition of Great Vessels/therapy , Female , Heart Septum , Humans , Infant , Infant, Newborn , Male , Transposition of Great Vessels/physiopathologyABSTRACT
Aortopulmonary window coexisting with tetralogy of Fallot (TF) was prospectively diagnosed by two-dimensional (2D) echocardiography and Doppler in an 18-month-old boy; the diagnosis was confirmed by cardiac catheterization and angiocardiography. Surgical correction was performed, but the patient died in the operating room from right ventricular dysfunction. The autopsy showed an adequate surgical repair, but the histologic examination of the lungs demonstrated severe pulmonary vascular disease, which was presumed to be the cause of death.