Asunto(s)
Enfermedades de la Mama/terapia , Lactancia , Pezones/patología , Femenino , Humanos , MasculinoRESUMEN
We present a patient in whom we successfully reconstructed a long segment of the proximal left vertebral artery in three dimensions using color Doppler transesophageal echocardiography (TEE). Three-dimensional (3-D) color Doppler TEE may complement two-dimensional (2-D) TEE by its ability to view cross sections of the left vertebral artery at any desired level from the 3-D data stored in the computer.
Asunto(s)
Ecocardiografía Doppler en Color/métodos , Ecocardiografía Transesofágica/métodos , Arteria Vertebral/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Procedimientos de Cirugía Plástica/métodos , Sensibilidad y Especificidad , Arteria Vertebral/anomalías , Arteria Vertebral/cirugíaRESUMEN
OBJECTIVES: TEE is performed in many patients with ischemic stroke, and it is possible to examine the proximal coronaries by TEE in these patients. Our purpose was to (1) determine the accuracy of transesophageal echocardiography (TEE) in the diagnosis of proximal coronary stenosis in patients with ischemic stroke and (2) show that TEE detection of proximal coronary stenosis changed management in a substantial number of patients. METHODS: Thirty-two patients with ischemic stroke undergoing TEE, in whom the proximal coronaries were examined and who had angiographic results available, were studied. RESULTS: Proximal coronaries were visualized as follows: left main (LM) in 31 (97%), left anterior descending (LAD) in 32 (100%), left circumflex (LCx) in 30 (94%) and right coronary artery (RCA) in 21 (66%). The sensitivity and specificity of TEE in diagnosing significant coronary stenosis in visualized vessels were as follows: LM 100% and 100%, LAD 100% and 95%, LCx 100% and 96%, and RCA 100% and 100%, respectively. When visualized and nonvisualized segments were considered, TEE detected significant stenosis as follows: 4 of 5 in the LM (80%), 13 of 13 in the LAD (100%), 2 of 3 in the LCx (66%), and 2 of 8 in the RCA (25%). Of the 32 patients, TEE results changed management in 17 patients (53%). Angiographic findings resulted in 10 of the 17 patients (59%) undergoing revascularization. CONCLUSIONS: TEE was very accurate in diagnosing significant coexisting coronary artery disease in patients with ischemic stroke. TEE diagnosis of these lesions prompted coronary angiography and subsequent revascularization in a substantial number of patients.
Asunto(s)
Estenosis Coronaria/diagnóstico , Estenosis Coronaria/epidemiología , Ecocardiografía Transesofágica/métodos , Accidente Cerebrovascular/epidemiología , Adulto , Anciano , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/diagnóstico por imagen , Isquemia Encefálica/epidemiología , Comorbilidad , Angiografía Coronaria/estadística & datos numéricos , Estenosis Coronaria/cirugía , Ecocardiografía Transesofágica/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Revascularización Miocárdica , Sensibilidad y EspecificidadRESUMEN
We present a patient in whom the exact location of a right atrial lipoma identified with two- and three-dimensional transesophageal echocardiography (2-D and 3-D TEE) was correlated with the surgical findings. By orienting the 3-D TEE images to conform to the view of the surgeon from the right side of the patient and referencing the site of attachment of the tumor to the surrounding structures, this lipoma was correctly localized to a 7 o'clock position in the right atrium.
Asunto(s)
Ecocardiografía Tridimensional , Ecocardiografía Transesofágica , Ecocardiografía , Atrios Cardíacos/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico , Lipoma/diagnóstico por imagen , Lipoma/diagnóstico , Anciano , Femenino , HumanosAsunto(s)
Infarto del Miocardio/complicaciones , Obstrucción del Flujo Ventricular Externo/complicaciones , Anciano , Cateterismo Cardíaco , Ecocardiografía , Femenino , Soplos Cardíacos/diagnóstico , Soplos Cardíacos/diagnóstico por imagen , Humanos , Infarto del Miocardio/diagnóstico por imagen , Obstrucción del Flujo Ventricular Externo/diagnóstico por imagenRESUMEN
Three-dimensional echocardiography is being used with increasing frequency to evaluate cardiac function and structure. We present two cases of prosthetic aortic valve endocarditis where three-dimensional transesophageal echocardiography correlated with the intraoperative surgical findings of prosthetic dehiscence and communication with an abscess cavity. When compared with two-dimensional transesophageal echocardiography, three-dimensional echocardiography was more accurate in defining the exact site of dehiscence and communication with an abscess cavity. The echocardiographic images were oriented as a clockface watch to conform to the surgeon's visualization of the aortic root as viewed from the right side of the patient.
Asunto(s)
Absceso/diagnóstico por imagen , Válvula Aórtica/diagnóstico por imagen , Ecocardiografía Transesofágica/métodos , Endocarditis Bacteriana/diagnóstico por imagen , Prótesis Valvulares Cardíacas/efectos adversos , Infecciones Relacionadas con Prótesis/diagnóstico por imagen , Absceso/etiología , Absceso/cirugía , Adulto , Válvula Aórtica/cirugía , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Insuficiencia de la Válvula Aórtica/etiología , Insuficiencia de la Válvula Aórtica/cirugía , Ecocardiografía Doppler en Color , Ecocardiografía Tridimensional , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/cirugía , Enterococcus , Infecciones por Bacterias Grampositivas/complicaciones , Infecciones por Bacterias Grampositivas/diagnóstico por imagen , Infecciones por Bacterias Grampositivas/cirugía , Humanos , Masculino , Persona de Mediana Edad , Falla de Prótesis , Infecciones Relacionadas con Prótesis/cirugía , Infecciones Estafilocócicas/diagnóstico por imagen , Infecciones Estafilocócicas/cirugíaAsunto(s)
Aorta Torácica/diagnóstico por imagen , Aorta Torácica/patología , Aneurisma de la Aorta/complicaciones , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/diagnóstico por imagen , Trombosis Intracraneal/complicaciones , Trombosis Intracraneal/diagnóstico por imagen , Anciano , Ecocardiografía Transesofágica , Humanos , MasculinoRESUMEN
We describe a patient with a left main coronary artery fistula with an opening at the superior vena cava-right atrial junction in whom three-dimensional transesophageal echocardiography permitted more accurate assessment of the shape and size of the communication site than two-dimensional transesophageal echocardiography.
Asunto(s)
Enfermedad Coronaria/diagnóstico por imagen , Ecocardiografía Doppler en Color , Ecocardiografía Tridimensional , Ecocardiografía Transesofágica , Fístula/diagnóstico por imagen , Adulto , Enfermedad Coronaria/cirugía , Femenino , Fístula/cirugía , HumanosAsunto(s)
Ecocardiografía Transesofágica , Fibroma/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico por imagen , Mixoma/diagnóstico por imagen , Válvula Tricúspide/diagnóstico por imagen , Adenocarcinoma/diagnóstico por imagen , Anciano , Neoplasias del Colon/diagnóstico por imagen , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Primarias Múltiples/diagnóstico por imagenRESUMEN
This article documents the ability of transesophageal echocardiography to provide adequate images and clinically relevant information about the coronary anatomy of the elderly patient. Transesophageal echocardiography is commonly used to assess elderly patients who suffer cerebral vascular accidents. It is important to evaluate not only for the usually suspected causes of a cardiac source of emboli but also for direct and indirect evidence of coronary artery disease--the leading cause of death in the elderly stroke patient. Because atherosclerotic cardiovascular diseases identified in one vascular bed are prone to universally involve the other vascular territories to some degree, it is not surprising that the coronary arteries are often stenotic. As a sudden event with catastrophic symptoms, a stroke is commonly the first vascular event the elderly patient experiences. Depending on the degree of recovery, physical limitations may contribute to the lack of symptoms from coexistent peripheral or coronary artery disease. Transesophageal echocardiography may be the first, or only, coronary evaluation for high-risk elderly patients.
Asunto(s)
Enfermedad Coronaria/diagnóstico por imagen , Ecocardiografía Transesofágica , Anciano , Puente de Arteria Coronaria , Enfermedad Coronaria/cirugía , Vasos Coronarios/diagnóstico por imagen , Oclusión de Injerto Vascular/diagnóstico por imagen , Humanos , Embolia Intracraneal/diagnóstico por imagen , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
In this case report we present two-dimensional (2-D) and three-dimensional (3-D) transesophageal echocardiographic (TEE) findings of a patient with lipomatous atrial septal hypertrophy and a patient with Hodgkin's lymphoma with atrial septal involvement. The echocardiographic characteristics that differentiate these two lesions are discussed.
Asunto(s)
Ecocardiografía Transesofágica , Neoplasias Cardíacas/diagnóstico por imagen , Lipoma/diagnóstico por imagen , Linfoma/diagnóstico por imagen , Anciano , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Humanos , Hipertrofia , MasculinoRESUMEN
We report a patient with traumatic aortic valve injury in whom a large defect in the noncoronary cusp of the aortic valve was clearly visualized by multiplane TEE and confirmed at surgery.
Asunto(s)
Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/lesiones , Ecocardiografía Transesofágica , Lesiones Cardíacas/diagnóstico por imagen , Heridas no Penetrantes/diagnóstico por imagen , Adulto , Válvula Aórtica/diagnóstico por imagen , Insuficiencia de la Válvula Aórtica/etiología , Insuficiencia de la Válvula Aórtica/cirugía , Estudios de Seguimiento , Lesiones Cardíacas/diagnóstico , Lesiones Cardíacas/cirugía , Prótesis Valvulares Cardíacas , Humanos , Masculino , Rotura/diagnóstico por imagen , Traumatismos Torácicos/diagnóstico por imagen , Resultado del TratamientoRESUMEN
This case report presents the unusual characteristics of a neuroendocrine thymic carcinoma that probably has metastasized to the left side of the interatrial septum from a primary thymic site.
Asunto(s)
Carcinoma Neuroendocrino/diagnóstico por imagen , Carcinoma Neuroendocrino/patología , Ecocardiografía Transesofágica , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/secundario , Neoplasias del Timo/patología , Anciano , Carcinoma Neuroendocrino/secundario , Atrios Cardíacos , Humanos , MasculinoRESUMEN
Coronary artery imaging is routinely obtained invasively at cardiac catheterization through coronary angiography. This remains the gold standard, but with advances in ultrasound technology, electron beam computed tomography, and magnetic resonance imaging, newer noninvasive methodologies are achieving greater success at imaging the coronary anatomy. This review is meant to highlight the important accomplishments from transesophageal echocardiographic (TEE) investigations that have studied the coronary arteries. The specific technique for optimally imaging the coronaries with high frequency transducers, color and conventional Doppler, in addition to contrast-enhanced methods, will be analyzed. Importantly, this article serves as a reminder to echocardiographers and cardiologists that excellent, clinically relevant information of the coronary arteries can be obtained routinely during TEE. This technique is part of the trend noted by the other authors in this special edition; that is, echocardiography is becoming the gold standard of the new millennium for many diagnostic areas, even coronary angiography.
Asunto(s)
Enfermedad Coronaria/diagnóstico por imagen , Ecocardiografía Transesofágica , Vasos Coronarios/diagnóstico por imagen , HumanosRESUMEN
We present a patient in whom power pulse inversion imaging clearly demonstrated a subendocardial myocardial perfusion defect during contrast vasodilator stress using adenosine. The defect was best appreciated with M-mode postprocessing of power pulse inversion imaging data.
Asunto(s)
Adenosina , Ecocardiografía , Endocardio/diagnóstico por imagen , Endocardio/patología , Perfusión , Síndrome del Robo de la Subclavia/diagnóstico , Vasodilatadores , Adenosina/administración & dosificación , Anciano , Ecocardiografía de Estrés , Humanos , Procesamiento de Imagen Asistido por Computador , MasculinoRESUMEN
We present a technique for transpharyngeal imaging of the bilateral carotid arteries completed towards the end of a transesophageal echocardiogram. To our knowledge, this is the first report that demonstrates the bifurcation of the right common carotid artery into the right internal and external carotid arteries with a transesophageal echocardiographic probe.
Asunto(s)
Ecocardiografía Transesofágica , Aumento de la Imagen , Faringe/irrigación sanguínea , Faringe/diagnóstico por imagen , Arteria Carótida Común/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana EdadRESUMEN
In this report, we present an adult patient with dwarfism who had severe aortic stenosis with markedly thickened fibrotic valve leaflets without calcification. These findings were well demonstrated by both two- and three-dimensional transesophageal echocardiography and confirmed at surgery and by pathological examination.
Asunto(s)
Estenosis de la Válvula Aórtica/diagnóstico por imagen , Enanismo/complicaciones , Ecocardiografía Transesofágica , Adulto , Válvula Aórtica/patología , Estenosis de la Válvula Aórtica/patología , Estenosis de la Válvula Aórtica/cirugía , Ecocardiografía , Ecocardiografía Doppler en Color , Ecocardiografía Tridimensional , Femenino , Fibrosis/patología , Implantación de Prótesis de Válvulas Cardíacas , HumanosRESUMEN
A man presented with acute chest and back pain with loss of consciousness. CT scan showed a mass in the arch that extended into the descending aorta. A diagnosis of type I aortic dissection was ultimately made by echocardiography. At surgery there was a circumferential intimal tear in the aortic root, and an intussuscepted dissection flap was retrieved from the arch and descending aorta.