OBJECTIVE To compare the determination of stroke volume (SV) and cardiac output (CO) using 2-dimensional (2D) versus 3-dimensional (3D) transesophageal echocardiography (TEE). DESIGN Prospective observational study. SETTING Tertiary care university hospital. PARTICIPANTS 35 patients without structural valve abnormalities undergoing isolated coronary artery bypass grafting. INTERVENTIONS...

Background Intra-ventricular pressure gradient along the direction of the outflow tract is generated by the impulse response of the myocardial contraction. This spatial pressure gradient, derived from the maximal acceleration estimates within flow along the left ventricular out flow tract (LVOT), has been validated in vitro by using MRI and was found strongly related to the inotropic state of t...

BACKGROUND Transthoracic echocardiography (TTE) is routinely used to calculate aortic valve area (AVA) by continuity equation (CE). However, accurate measurement of the left ventricular outflow tract (LVOT) can be difficult and flow acceleration in the LVOT may lead to miscalculation of the AVA. OBJECTIVE The aim of our study was to compare AVA measurements by standard TTE, cardiac magnetic r...

OBJECTIVES The authors propose a novel transcatheter transection of the anterior mitral leaflet to prevent iatrogenic left ventricular outflow tract (LVOT) obstruction during transcatheter mitral valve replacement (TMVR). BACKGROUND LVOT obstruction is a life-threatening complication of TMVR caused by septal displacement of the anterior mitral leaflet. METHODS In vivo procedures in swine we...

A 59-year-old male with a past medical history of obesity (BMI=31), controlled hypertension (HTN) and hyperlipidemia (HLD), presented for evaluation of new exertional dyspnea of three weeks duration. He reported difficulty climbing one flight of stairs in his house; six months ago he was able to exercise without limitations. He also complained of palpitations which he described as intermittent,...

OBJECTIVES This study was conducted to evaluate follow-up results in patients with hypertrophic obstructive cardiomyopathy (HOCM) who underwent either percutaneous transluminal septal myocardial ablation (PTSMA) or septal myectomy. BACKGROUND Controversy exists with regard to these two forms of treatment for patients with HOCM. METHODS Of 51 patients with HOCM treated, 25 were treated by PT...

OBJECTIVE The goal of this study was to analyze left ventricular outflow tract systolic acceleration (LVOT(Acc)) during alterations in left ventricular (LV) contractility and LV filling. BACKGROUND Most indexes described to quantify LV systolic function, such as LV ejection fraction and cardiac output, are dependent on loading conditions. METHODS In 18 sheep (4 normal, 6 with aortic regurgi...

Intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) facilitates an understanding of the complex cardiac pathology that is not fully delineated in a two-dimensional (2D) echocardiographic evaluation, and it suggests earlier and more precise surgical planning and intraoperative decision making. In the present case, the intraoperative 2D-TEE midesophageal long-axis view in...

A 56-year-old man who complained of quadrantic hemianopsia was admitted to determine its etiology. Cerebral angiography revealed no organic stenosis. Echocardiography showed clear direct continuity between a hypertrophied anterolateral papillary muscle and the anterior mitral leaflet, and the left ventricular (LV) outflow tract (LVOT) was narrowed by the presence of an accessory papillary muscl...

This study investigated the effects of alcohol septal ablation (ASA) on microcirculatory function and myocardial energetics in patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction. In 15 HCM patients who underwent ASA, echocardiography was performed before and 6 mo after the procedure to assess the LVOT gradient (LVOTG). Additionally, [(15)O]wate...