Echocardiography
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Accurate calculation of left ventricular ejection fraction (LVEF) is important for diagnostic, prognostic and therapeutic reasons. Cardiac magnetic resonance (CMR) is the reference standard for LVEF calculation, followed by real time three-dimensional echocardiography (RT3DE). Limited availability of CMR and RT3DE leaves Simpson's rule as the two-dimensional echocardiography (2DE) standard by which LVEF is calculated. We investigated the accuracy of the 16-Segment Regional Wall Motion Score Index (RWMSI) as an alternative method for calculating LVEF by 2DE and compared this to Simpson's rule and CMR. ⋯ RWMSI-LVEF correlates strongly with CMR with good intertechnique agreement. In centers where CMR and RT3DE are not readily available, the use by experienced individuals, of the RWMSI for calculating LVEF may be a more simple, accurate, and reliable alternative to Simpson's rule.
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Case Reports
Double atrial septal defect: diagnosis and closure guidance with 3D transesophageal echocardiography.
Atrial septal defect (ASD) is a common form of congenital heart disease that often persists well into adulthood before discovery or intervention. The authors report the case of a patient referred for routine percutaneous ASD closure that was found on three-dimensional (3D) transesophageal echocardiography to have two large separate ostium secundum defects which were subsequently closed under 3D echocardiographic guidance.
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We describe an elderly patient undergoing ablation for atrial fibrillation in whom, two-dimensional transesophageal echocardiography showed a mass-like lesion in or adjacent to left atrial appendage (LAA). This mass-like effect was produced by en face visualization of the top of a LAA lobe in the presence of a small effusion in the transverse sinus of the pericardium.