1/147. Discrete subaortic valvular stenosis: the clinical utility and limitations of transesophageal echocardiography.Transesophageal echocardiography (TEE) is a useful technique in the diagnosis and intraoperative assessment of discrete subaortic stenosis (DSS). It allows clear visualization of the subaortic membrane, which may be missed by transthoracic echocardiography, differentiates DSS from other causes of left ventricular outflow tract obstruction, and accurately detects the presence of associated aortic regurgitation and bacterial endocarditis. Limitations in its use include inadequate visualization of the left ventricular outflow tract by TEE in the presence of a prosthetic mitral valve or mitral annular calcification, and improper alignment of the Doppler cursor across the outflow tract.- - - - - - - - - - ranking = 1keywords = valve (Clic here for more details about this article) |
2/147. diagnosis of accessory mitral valve tissue by transesophageal echocardiography.Accessory mitral valve tissue is a rare cause of intracardiac mass and subvalvular left ventricular outflow tract obstruction. The preoperative diagnosis of this congenital anomaly has been facilitated by transthoracic two-dimensional and Doppler echocardiography. However, transthoracic two-dimensional echocardiography cannot identify or correctly diagnose all cases of accessory mitral valve tissue. We report a patient in whom an intracardiac mass detected by transthoracic echocardiography was definitively diagnosed as accessory mitral valve tissue by transesophageal echocardiography.- - - - - - - - - - ranking = 7keywords = valve (Clic here for more details about this article) |
3/147. Aortoventriculoplasty after a prior posterior root enlargement (Manougian): case report.A patient with congenital bicuspid aortic stenosis had an open commissurotomy followed 3 years later by a Manougian's operation along with an aortic valve replacement. Nine years later, due to residual aortic stenosis, a Konno's anterior root enlarging procedure with an aortic valve replacement was successfully done. Good relief of aortic and subaortic stenosis and the absence of significant gradient across the left ventricular outflow tract led us to believe that successful and effective relief could be obtained by adding a Konno-type of enlargement to a previously performed posterior enlargement procedure.- - - - - - - - - - ranking = 2keywords = valve (Clic here for more details about this article) |
4/147. Echocardiographic diagnosis of left ventricular outflow tract obstruction caused by an acquired subaortic membrane after mitral valve replacement.Although an acquired subaortic membrane has been reported as a cause of left ventricular outflow tract (LVOT) obstruction in various clinical settings, it previously has not been reported after mitral valve surgery. We describe 3 cases of acquired LVOT obstruction that resulted from development of a subaortic membrane after mitral valve replacement. This report emphasizes the role of an acquired subaortic membrane in LVOT obstruction after mitral valve replacement, the use of echocardiography in diagnosing this condition, and the importance of early intervention.- - - - - - - - - - ranking = 7keywords = valve (Clic here for more details about this article) |
5/147. Critical obstruction of the right ventricular outflow tract by a primary hemangioendothelioma in a seven month old.A 7-month-old presented with failure to thrive and a murmur. echocardiography demonstrated a large mass in the right ventricular outflow tract, extending through the pulmonary valve. During anaesthetic induction this caused critical obstruction of the outflow tract and cardiac arrest. Pathological diagnosis showed the lesion to be a primary hemangioendothelioma. Despite surgical excision and steroid therapy, the mass continued to grow for a period of 8 weeks, but then began to regress spontaneously.- - - - - - - - - - ranking = 20.81581192079keywords = pulmonary valve, valve (Clic here for more details about this article) |
6/147. Fatal neonatal hypertrophic cardiomyopathy with severe stenosis of the right ventricular outflow tract: echocardiographic diagnosis and potential therapy.We discuss the clinical course of aneonate with idiopathic hypertrophic cardiomyopathy who showed rapid progression of stenosis of the right ventricular outflow tract and reduction in size of the right ventricular cavity due to thicken ing of the ventricular septum. Medical treatment proved unsuccessful. We suggest that balloon atrial septostomy combined with construction of a Blalock-Taussig shunt may be effective in view of the hemodynamics, which mimic pulmonary atresia with intact interventricular septum.- - - - - - - - - - ranking = 2.9354518364789keywords = pulmonary atresia, atresia (Clic here for more details about this article) |
7/147. Congenital subaortic stenosis by accessory mitral valve tissue, recognition and management.Accessory mitral valve tissue as the single cause for left ventricular outflow tract obstruction is a very rare cardiac malformation in normally connected hearts. We report a case in which this condition was present as single cause for left ventricular outflow tract obstruction. The surgical technique is described and a review of the literature presented.- - - - - - - - - - ranking = 5keywords = valve (Clic here for more details about this article) |
8/147. Ventricular thrombus and subarachnoid bleeding during support with ventricular assist devices.We report the case of a 23-year-old man with acute aortic valve insufficiency caused by endocarditis, who after emergency aortic valve replacement developed biventricular heart failure. The heart failure was treated with temporary assist devices. Subarachnoid bleeding and thrombus obstruction of the left ventricular outflow tract was detected. The postoperative course is presented with special emphasis on management of subarachnoid bleeding and the simultaneous use of anticoagulation necessary for ventricular assist devices.- - - - - - - - - - ranking = 2keywords = valve (Clic here for more details about this article) |
9/147. aortic valve stenosis with left ventricular outflow tract pressure gradient.A 61-year-old man was diagnosed with severe aortic valve stenosis with left ventricular outflow tract pressure gradient due to systolic anterior movement of the mitral valve and a large poststenotic dilation of the ascending aorta. He underwent successful aortic root replacement and concomitant septal myectomy.- - - - - - - - - - ranking = 6keywords = valve (Clic here for more details about this article) |
10/147. Fixed left ventricular outflow tract obstruction in presumed hypertrophic obstructive cardiomyopathy: implications for therapy.BACKGROUND: A subset of patients presenting with a presumed diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) have a fixed left ventricular outflow tract (LVOT) obstruction. Recognition of this pathophysiologic abnormality is important in choosing therapy. methods: Of patients referred for treatment of HOCM, 4 had fixed LVOT obstruction. Clinical and echocardiographic data and surgical findings were reviewed. RESULTS: In the 4 patients with clinical features consistent with HOCM or HOCM-like conditions, echocardiography showed fixed LVOT obstruction with an early-peaking LVOT Doppler signal or absence of severe systolic anterior motion of the mitral valve. The causes of fixed obstruction included accessory mitral tissue with associated fibrous ring (1 patient), fixed subaortic tunnel stenosis (2 patients), and a discreet subaortic ridge (1 patient). After surgical relief of the fixed LVOT obstruction, all patients had relief of the ventricular outflow tract gradient. CONCLUSIONS: Not all patients with a presumed diagnosis of HOCM have isolated dynamic LVOT obstruction but may have isolated or additional fixed obstruction. Careful two-dimensional and Doppler echocardiography are needed to identify this subset of patients who are best treated surgically.- - - - - - - - - - ranking = 1keywords = valve (Clic here for more details about this article) |
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