Basic Principles Incidence and Predisposing Factors Among patients with acute chest pain, a cardiac cause (most often acute myocardial infarction) is responsible for less than 20% of cases ( Fig. 32.1 ). Aortic disease accounts for less than 1% of…
The use of transesophageal echocardiography (TEE) in the operating room has evolved from a simple tool to look at ventricular wall motion to a powerful diagnostic modality for examining every facet of cardiac and noncardiac surgery. Its use has improved…
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Atrial septum CASE 14-1 Anatomy and imaging of atrial septum See Case 7-1 in Chapter 7 , Adult Congenital Heart Disease. CASE 14-2 PFO device closure for recurrent transient neurological events About 3 years ago this 44-year-old female had an…
Transcatheter aortic valve replacement Since the first transcatheter bioprosthetic aortic valve was implanted, changes have included smaller and more flexible delivery systems for use in smaller vessels; lower frame height in order to minimize interference with coronary blood flow, mitral…
In addition to standard cardiopulmonary bypass during cardiac surgery, there now are several options for longer-term mechanical circulatory support ranging from a simple intraaortic balloon pump to a total artificial heart. Some of these devices are used in the hospital…
Normal variants CASE 11-1 Left atrial appendage TEE is often requested before electrical cardioversion or catheter ablation for atrial fibrillation to evaluate the left atrial appendage for the presence of thrombus. Adequate visualization of the atrial appendage requires at least…
Pseudoaneurysms CASE 10-1 Aortic pseudoaneurysm after avr with anterior extension This 41-year-old man with Reiter’s syndrome underwent mechanical aortic valve replacement 9 years ago for aortic regurgitation. Four months ago he developed prosthetic valve endocarditis. He was treated with antibiotics…
CASE 9-1 Pericardial effusion Examples of pericardial effusions seen on intraoperative TEE in several different patients are shown. Comments A pericardial effusion is diagnosed based on the echocardiographic finding of an echo-lucent area around the heart. Pericardial effusions are usually…
CASE 8-1 Transplant for hypertrophic cardiomyopathy This 26-year-old woman with hypertrophic cardiomyopathy and prolonged QT syndrome was referred for heart transplantation for low-output heart failure with clinical symptoms of fatigue and marked exercise intolerance with New York Heart Association (NYHA)…