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  • 1
    ISSN: 1432-1971
    Schlagwort(e): Absence of pulmonary valve ; Imperforate tricuspid valve
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Nine cases of imperforate tricuspid valve associated with dysplasia of the right ventricular myocardium, pulmonary valve, and right coronary artery are described. The mean frontal QRS axis of the electrocardiograms did not indicate left axis deviation in seven of the nine. Two-dimensional echocardiograms showed an imperforate tricuspid valve, normally aligned atrioventricular septum, and an irregular-shaped right ventricular cavity with a thin wall. In three cases with absence of the pulmonary valve, pulsed Doppler echocardiograms of the right ventricular outflow tract revealed antegrade flow during systole and retrograde flow during diastole, and selective angiography through a persistent ductus arteriosus showed retrograde filling of the blind-ended right ventricular cavity via the main pulmonary artery. Necropsy examinations showed an imperforate tricuspid valve with a thin-walled aneurysmal right ventricle in all six cases examined. Pulmonary atresia was observed in two cases, and the absence of the pulmonary valve in four. The right coronary artery was hypoplastic in four cases and absent in two. A shunt operation should be carried out in early infancy to prevent hypoxia after closure of the ductus arteriosus.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1432-1971
    Schlagwort(e): Right coronary artery to left ventricle fistula ; Two-dimensional echocardiography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary A 12-year-old boy with a decrescendo diastolic murmur maximal at the lower right sternal border was suspected of having a coronary arteriovenous fistula. Cardiac catheterization and angiography revealed a right coronary artery to left ventricle fistula with marked dilatation of the right coronary artery. This is the thirteenth case of this anomaly reported in the literature. Characteristic two-dimensional echocardiographic features of this case are presented. A markedly dilated right coronary artery was revealed by two-dimensional echocardiography to take a normal right coronary artery course and empty into the posteromedial portion of the left ventricle. This case indicates the possibility of visualizing a dilated peripheral portion of the right coronary artery using two-dimensional echocardiography.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 1615-2573
    Schlagwort(e): Total anomalous pulmonary venous connection ; Two-dimensional Doppler color flow-mapping echocardiography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Ten patients with total and one with partial anomalous pulmonary venous connection were studied by two-dimensional Doppler color flow-mapping echocardiography. In cases of anomalous pulmonary venous drainage into the innominate vein through the vertical vein, flow away from the transducer was detected in the echo space behind the atria in the subxiphoid four-chamber approach. In the suprasternal approach, flow toward the transducer was detected at the junction of the vertical and innominate veins. In the case of an anomalous pulmonary vein connecting directly into the superior vena cava, an area of flow toward the transducer, which was triangular in shape, was detected in the dilated superior vena cava. In the two cases in which the pulmonary vein drained into the coronary sinus, the flow toward the transducer was observed at the ostium of the coronary sinus in the subxiphoid four-chamber view, and it appeared as if the blood flow was emerging from this point. In a case of the paracardiac type of total anomalous pulmonary venous connection with drainage into the posterior wall of the right atrium, the flow toward the transducer occurred higher in the right atrium than in the cases with drainage into the coronary sinus. In a case with the infradiaphragmatic type of total anomalous pulmonary venous connection, continuous flow toward the transducer, which passed through the diaphragm in an anomalous vessel, was detected from the subxiphoid area. The downward flow in the anomalous vessel changed to an upward flow at the site of drainage into the hepatic vein. We conclude that the site of drainage in patients with total and partial anomalous pulmonary venous connection can be detected easily and without fail using two-dimensional Doppler color flow mapping.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    ISSN: 1615-2573
    Schlagwort(e): Wall stress ; Incremental areal strain ; Reciprocal of wall thickness ; Regional work
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary A new method of defining regional mechanical work done by a unit volume of myocardium of the ventricular wall and evaluating regional cardiac function is proposed. This method uses the relationship between mean wall stress (σ) and the natural logarithm of the reciprocal of wall thickness (ln(1/H)). 1/H at a point on the epicardial surface is proportional to the regional area (A) of the ventricular wall containing that point. The value for regional work obtained from the relationship between theσ and lnA orσ and ln(1/H) has a true dimension of work, i.e., [J/m3]. Theσ — ln(1/H) relationship was studied in ten anesthetized dogs. Wall thickness and internal diameter of the left ventricle were measured with ultrasonic dimension gauges. Regional work per unit volume of myocardium multiplied by the total myocardial volume of the left ventricle correlated well with the total mechanical work of the entire left ventricle calculated from the pressure-volume relationship during pressure loading, contractility change, and volume loading. During pressure loading, the end-systolicσ — ln(1/H) relationship showed linearity. After bolus injection of isoproterenol theσ — ln(1/H) loop shifted to the left. We concluded that theσ — ln(1/H) relationship provides a method of characterizing regional function normalized to the unit volume of myocardium. In addition, our methods have a potential for echocardiographic application.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 5
    ISSN: 1615-2573
    Schlagwort(e): Blood flow velocity ; Velocity profile ; Multichannel Doppler echocardiography ; Intravascular flow dynamics
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary We observed instantaneous blood flow velocity profiles at the right and left ventricular outflow tracts, the ascending aorta, and the lower thoracic aorta in human subjects using a newly devised method of real-time multichannel Doppler echocardiography. In 20 apparently healthy subjects, the blood flow velocity profile was successfully obtained in all cases at the right and left ventricular outflow tracts—in 13 cases at the ascending aorta, in 12 cases at the aortic arch, and in ten cases at the lower thoracic aorta. The configuration of the profile was almost flat during systole at the left ventricular outflow tract, the ascending aorta, and the descending aorta. The profile was triangular at the right ventricular outflow tract, where the velocity was faster at the ventricular septal side than at the free wall side, and it was also triangular at the aortic arch, where the velocity was faster at the inner side of the arch than at the outer side. These observations were very similar to those reported by others in previous experimental studies. Thus, the present study demonstrates that it is possible to record nonivasively the instantaneous blood flow velocity profile in humans using this new Doppler echocardiographic instrument.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    Heart and vessels 1 (1985), S. 101-113 
    ISSN: 1615-2573
    Schlagwort(e): Segmental approach ; Two-dimensional echocardiography ; Congenital heart disease
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary A two-dimensional echocardiographic (2-DE) method of segmental approach for diagnosis of congenital heart disease is presented. Firstly, the visceroatrial situs is determined, i.e., whether it is solitus, inversus, or ambiguous, by identifying the inferior vena cava to right atrium junction. Secondly, it is ascertained whether the ventricular loop is D-loop or L-loop. The ventricular loop is determined by identifying the internal structure of the right and left ventricles by 2-DE. Thirdly, the spatial relationships of the great arteries are determined by identifying the pulmonary artery and aorta. The pulmonary artery is identified by its branches, and the other artery is the aorta. Fourthly, the atrioventricular connection is determined as follows: (1) usual alignment, (2) criss-crossing, (3) straddling, (4) double inlet, and (5) unilateral atrioventricular valve atresia, by using an apical four-chamber echo view. Finally, the ventriculo-great arterial relationship is determined from the apical four-chamber echo view with a tilting maneuver or by echocardiographic recognition of the existence of the fibrous continuities. Following this echocardiographic “five-step approach,” hemodynamic considerations should be included, and by integrating all the information the diagnosis of congenital heart disease is completed.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 7
    ISSN: 1615-2573
    Schlagwort(e): Absent right superior vena cava ; Contrast cross-sectional echocardiography ; Enlarged coronary sinus
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary We report a case of absence of the right superior vena cava. Hitherto, the findings in this condition have only been obtained using invasive methods; this report is the first in which the diagnosis was made by means of echocardiography. The findings include a markedly enlarged coronary sinus draining into the right atrium and a specific finding of contrast echocardiography in which contrast material injected into the right antecubital vein can be seen in the enlarged coronary sinus. The contrast echo flows into the right atrium from the coronary sinusonly. The size of the coronary sinus was far beyond the range (91±38 mm2/m2) in patients with persistent left superior vena cava with the presence of the right superior vena cava.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 8
    Digitale Medien
    Digitale Medien
    Springer
    Heart and vessels 7 (1992), S. 99-103 
    ISSN: 1615-2573
    Schlagwort(e): Congenital heart disease ; Vascular sling ; Color Doppler echocardiography ; Transesophageal echocardiography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Three patients with vascular sling were studied by two-dimensional and color Doppler echocardiography and angiocardiography. One case was associated with atrial septal defect and another with tetralogy of Fallot and patent ductus arteriosus. The third case had no associated intracardiac anomalies. Color Doppler flow mapping was performed in all three patients, and transesophageal echocardiography was studied in two patients. Color Doppler echocardiography showed the characteristic features of this congenital anomaly in all three patients, especially in detecting the site of anomalous origin of the left pulmonary artery. A small patent ductus arteriosus was misinterpreted as the normal left pulmonary artery in one patient. Small pulmonary arteries in the patient with tetralogy of Fallot made the diagnosis difficult. Using transesophageal echocardiography, we clearly identified the trachea, esophagus, and abnormal left pulmonary artery.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 9
    ISSN: 1615-2573
    Schlagwort(e): Stent ; Balloon dilatation ; Pulmonary artery stenosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary This study was performed to determine the efficacy of balloon-expandable stents in the treatment of branch pulmonary artery-stenoses and conduit stenosis in children. A total of eight stainless steel stents were implanted in seven patients. Three patients had tetralogy of Fallot with pulmonary artery stenosis following total correction, one patient had conduit stenosis following correction of transposition of the great arteries, one patient had intra-cardiac conduit stenosis after septation for single left ventricle, and two patients had pulmonary artery stenosis after Fontan operation. Six stents were placed in the branch pulmonary arteries, one in the extracardiac conduit, and one in the intracardiac conduit. The mean age at implantation was 13 ± 3 years and the mean weight 37 ± 12kg. Follow-up time ranged from 0.3–2 years. The diameter of pulmonary arteries with stenoses increased from 5.6 ± 2.2 mm to 10.6 ± 1.8 mm (n = 7). The systolic pressure gradient decreased from 56 ± 26 mmHg to 22 ± 16 mmHg (n = 5). No embolization or thrombotic event has been noted. One stent placed in the intracardiac conduit was compressed and fractured. These data indicate that balloon-expandable stents are useful in the treatment of pulmonary artery branch stenoses and extracardiac conduit stenosis in children. The use of stents for intracardiac stenosis may result in stent fracture.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 10
    ISSN: 1615-2573
    Schlagwort(e): Pulsed and color Doppler echocardiography ; Coronary artery fistula
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary In a 48-year-old woman, the diagnosis of a right coronary arteriovenous fistula communicating with the coronary sinus was made noninvasively using two-dimensional, pulsed and color Doppler echocardiography. These noninvasive techniques were superior to angiography in delineating the cardiac chamber into which the fistula emptied.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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