Assuntos
Ecocardiografia , Doenças das Valvas Cardíacas , Adulto , Intervalo Livre de Doença , Feminino , Seguimentos , Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/mortalidade , Doenças das Valvas Cardíacas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida , Fatores de TempoRESUMO
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.
Assuntos
Valva Aórtica/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia Transesofagiana/métodos , Doenças das Valvas Cardíacas/diagnóstico , Adulto , Valva Aórtica/anormalidades , Valva Aórtica/cirurgia , Feminino , Seguimentos , Doenças das Valvas Cardíacas/cirurgia , Humanos , Período Intraoperatório , Masculino , Reprodutibilidade dos Testes , Estudos RetrospectivosAssuntos
Pericardite/diagnóstico , Doença Aguda , Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Técnicas de Imagem Cardíaca , Dor no Peito/etiologia , Colchicina/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Eletrocardiografia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pericardite/tratamento farmacológico , Pericardite/etiologiaRESUMO
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.
Assuntos
Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Anomalias dos Vasos Coronários/diagnóstico , Tomografia Computadorizada Multidetectores/métodos , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças RarasRESUMO
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.
