Cardiology
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Case Reports
Transesophageal echocardiography as an important tool in the diagnosis of postinfarction papillary muscle rupture.
Papillary muscle complicating acute myocardial infarction is an uncommon but potentially catastrophic event. We present 3 such cases to illustrate the difficulties in early identification of rupture. In each case, transesophageal echocardiography was employed providing rapid and unequivocal identification of the disorder. Prompt surgical intervention led to survival in 2 patients.
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Comparative Study
Lack of a thrombotic tendency in patients with acute myocardial infarction and angiographically normal coronary arteries.
The hematological profile of 12 patients with acute myocardial infarction and normal coronary arteriographic findings was compared to that of 8 patients with acute myocardial infarction associated with obstructive coronary artery disease, and of 12 patients with no evidence of myocardial infarction and normal coronary arteriographic and left ventriculographic findings who served as control. There were no significant differences in the hematological profile among the 3 groups, suggesting lack of a thrombotic tendency in patients with acute myocardial infarction and normal coronary arteriographic findings.
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The aim of this study was to assess the performance of pediatric-size oximetry catheters in diagnostic heart catheterization. Measurements of pressures and oxygen saturations were obtained with oximetry catheters as well as with standard methods during routine heart catheterizations in 10 infants and children with congenital heart defects. ⋯ Oxygen saturation measurements exhibited bias and scatter. It is concluded that no advantage is obtained by the use of oximetry catheters in diagnostic heart catheterization in children and infants.
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Clinical Trial Controlled Clinical Trial
Left atrial appendage function determined by transesophageal echocardiography in patients with rheumatic mitral valve disease.
Left atrial thrombi have been considered to be the major source of systemic arterial embolization in patients with rheumatic mitral valve disease. Almost half of the left atrial thrombi are found in the left atrial appendage (LAA). To investigate LAA size and LAA contractile function in patients with rheumatic mitral valve disease, transesophageal echocardiographic and Doppler studies were performed in 61 patients. ⋯ LAA ejection fraction and LAA peak emptying velocity were lower in this group, too. A higher incidence of LAA SEC formation was found in these patients with rheumatic mitral valve disease (4/15 vs. 0/22; p = 0.021). There was no significant difference, however, in LAA thrombus formation between group 2 and its control group (1/15 vs. 1/22; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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Emergency cardiopulmonary support has been used in the United States since 1986, mainly by physicians at participating centers for the National Registry of Elective Supported Angioplasty. Data from the National Registry as well as the experience in three institutions from a number of operators were analyzed to assess the benefits of the emergency cardiopulmonary support application in patients with hemodynamic collapse. Patients who had experienced either cardiac arrest or hemodynamic collapse with cardiogenic shock unresponsive to pressors were placed emergently on cardiopulmonary support. ⋯ A two-center experience has demonstrated a 69% survival rate. Patients treated with emergency cardiopulmonary support who have experienced hemodynamic collapse have improved survivorship over any other hemodynamic support system. With increasing experience by the operators, the results have improved for survivorship, particularly in the early application group.