[Percutaneous closure of an interatrial communication via the internal jugular route using an Amplatzer prosthesis].

Closure of interatrial communications by interventional catheterisation is recommended and effective. The usual approach is via the femoral vein. However, difficulty in positioning the probe and the guide in a stable fashion across the septal defect occurred during closure of the interatrial communication by the percutaneous route in a 71 year old female with severe scoliosis.

Assessment of muscular ventricular septal defect closure by transcatheter or surgical approach: a three-dimensional echocardiographic study.

Aims: Previous classification of muscular ventricular septal defects (VSDs) visualized on two-dimensional echocardiography relied on artificial divisions of the septum. New visualization of the ventricular septum integrating the third dimension would facilitate communication between cardiologists and surgeons. The objectives of this study were (1) to assess in patients with muscular ventricular septal defects the accuracy of left ventricular three-dimensional echocardiographic reconstructions in demonstrating the position, the size and the tissue rims of the defects; (2) to compare findings by three-dimensional echocardiography with those obtained by surgical and transcatheter approaches.

[3D-transthoracic echocardiography: a selection method prior to percutaneous closure of atrial septal defects].

Prior to putting in place a percutaneous device, the assessment of the atrial septal defect anatomy is mandatory. The 3D transthoracic echocardiography is a non-invasive method bringing an imaging of the septal defect surface and its borders. Fifty-two patients ageing from 3 to 16 years old had a rotational 3D transthoracic echocardiography.

[Atrial septal defect calibration: comparison of methods using balloons and 3D-transesophageal echocardiography].

The atrial septal defects (ASDs) occlusion by cardiac catheterization is an alternative to the surgical technique. The use of stretching by balloon is considered as the gold-standard for the ASDs calibration. Three dimensional transesophageral echocardiography (3D-TEE) brings an imaging of the ASD surface and allows the measurement of its maximal diameter.

Improvement in left ventricular hypertrophy and left ventricular diastolic function following verapamil therapy in mild to moderate hypertension.

We evaluated the effect of verapamil therapy on left ventricular hypertrophy and left ventricular diastolic function in 13 patients with mild to moderate hypertension. Left ventricular hypertrophy was determined by M-mode echocardiographic measurements of interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) both before (T0) and after 3 months (T3) of verapamil therapy. Left ventricular diastolic transmitral flow was measured by pulsed Doppler indices of early (E) and atrial (A) velocity, E/A ratio, total area (Ta), A area (Aa), Aa/Ta ratio, E-pressure half-time (E-PHT).

[Study of left ventricular diastolic function using pulsed Doppler in myocardial infarct in hypertensive subjects].

To determine if impairment of left ventricular filling is influenced by acute myocardial infarction in patients with arterial hypertension, left ventricular diastolic function was assessed by pulsed doppler echocardiography in 46 patients (pts) subdivided into four groups (Gr): G.1 (n = 12 pts) with acute myocardial infarction and hypertensive heart disease. G.

[Prognostic value at 12 months of two-dimensional echocardiography performed during the acute phase of myocardial infarction. A prospective study of 140 patients].

A two-dimensional echocardiography was performed in the acute phase of myocardial infarction in 140 consecutive patients admitted to hospital for transmural infarction 12 +/- 3 days on average after necrosis was formed. The examination consisted of 4 ventricular sections, including 2 through the apex: 8 ventricular segments were individualized, to be interpreted only when 50 p. 100 of the endocardium was visualized.

[Echocardiographic evaluation of intravenous streptokinase in myocardial infarction in the acute phase].

The effects of intravenous fibrinolysis on left ventricular function in acute myocardial infarction were investigated by two-dimensional echocardiography in patients aged less than 70 for whom fibrinolysis was not contra-indicated and who were admitted less than 6 hours after the onset of a first myocardial infarction without heart failure. The 12 patients thus recruited were male; their mean age was 55 years and the infarct was anterior in 6 cases and posterior in 6 cases. Streptokinase was administered first by bolus intravenous injection (250,000 IU over 20 min), then by intravenous infusion (100,000 IU over 12 hours); this was followed by heparin.

Value of respiratory variations of right ventricular dimension in the identification of small atrial septal defects (secundum type) not requiring surgery: an echocardiographic study.

In search of reliable criteria that could help differentiate insignificant atrial septal defects (ASDs) from those with a large shunt, M-mode echocardiograms of three groups of patients were studied retrospectively: group I = 10 normal children (mean age 5.7 years); group II = 10 patients (mean age 7 years) with small ASD in whom the decision was taken not to proceed to surgical closure, based on hemodynamic and angiographic criteria; and group III = 15 patients (mean age 7 years) with an "operable" shunt, who underwent corrective surgery. The results showed that right ventricular end-diastolic dimensions during expiration (RVDDE) were increased in all patients in group III but were normal in only 3 of the 10 patients in group II.

[Respiratory variations in the right ventricular diameter: an echocardiographic element in the diagnosis of partial isolated pulmonary venous return anomaly].

Isolated partial anomalous pulmonary venous drainage (PAPVD), in contrast to atrial septal defect (ASD), does not cancel out the effects of respiration on blood flow in the right ventricle. The aim of this study was to see whether this difference could contribute to the diagnosis of PAPVD without ASD on M mode echocardiography. The diastolic dimensions of the right ventricle on expiration and inspiration were compared in 4 groups of patients aged 2 to 17 years.

[Prognostic indices of the normalization of left ventricular function in chronic aortic insufficiency following valve replacement].

The aim of this study of 31 patients was to identify M mode echocardiographic parameters predictive of normalisation of left ventricular function after valvular replacement for chronic aortic incompetence in order to determine the optimal time for surgery. Only patients with chronic, pure aortic incompetence (ventriculo-aortic pressure gradient less than or equal to 30 mmHG) were considered. At the time of investigation 4 patients were in functional Class I, 6 in Class II, 10 in Class III and 11 in Class IV (NYHA).

[Systemic fibrinolytic treatment in the acute phase of myocardial infarction. Effects on coronary repermeation and left ventricular function].

Coronary angiography and 2D echocardiography were performed at the 24th hour and 21st day of acute myocardial infarction in 18 patients to study the effects of peripheral fibrinolytic therapy on coronary repermeabilisation and left ventricular function. The treatment was the same for all patients included in the study. The left ventricular ejection fraction and sequential left ventricular contractility were analysed.

Influence of age on wall thickness, cavity dimensions and myocardial contractility of the left ventricle in simple transposition of the great arteries.

This study was carried out to establish a reference table of echocardiographic values for the left ventricle of simple d-transposition of the great arteries (d-TGA) and to determine at what age left ventricular dimensions in these patients become different from those of a normal population. Fifty-three patients with d-TGA and normal pulmonary pressure and 395 normal children ages 1 day to 10 years were studied by M-mode echocardiography. Results show that in d-TGA, left ventricular systolic and diastolic internal diameters are normal at birth.

Renal transplantation and cardiac function in pediatric patients.

Nine pediatric patients underwent echocardiographic evaluation prior to and after renal transplantation. Prior to transplantation parameters of cardiac contractility such as mean velocity of circumferential fiber shortening, ejection time, ejection fraction and shortening fraction were within the normal ranges for the age group. Post transplantation there was a significant decrease in heart rate and cardiac index.

Hang-out time of pulmonary valve in d-transposition of great arteries.

Recently it has been shown that in patients with transposition of the great arteries the isometric relaxation time of the left ventricle could be negative in the presence of normal pulmonary artery pressure. In order to find an explanation for this apparently paradoxical situation, it was decided to evaluate the importance of the delay of closure of the pulmonary valve in 15 patients with transposition of the great arteries. This delay is called the hang-out time.