Effect of treatment on the incidence of stroke and other emboli in 519 patients with severe thoracic aortic plaque.

Severe aortic plaques seen on transesophageal echocardiography (TEE) are a high-risk cause of stroke and peripheral embolization. Evidence to guide therapy is lacking. Retrospective information was obtained regarding the occurrence of embolic events (stroke, transient ischemic attacks, or peripheral emboli) in 519 patients with severe thoracic aortic plaque seen on TEE since 1988.

Is it open or is it closed? Thrombosis of a St. Jude's tricuspid valve prosthesis.

A 49-year-old woman with mitral and tricuspid mechanical valve prostheses developed marked weight gain with increasing abdominal girth and facial plethora 4 weeks after anticoagulation was temporarily interrupted for abdominal surgery. Transthoracic and transesophageal echocardiography documented severe tricuspid stenosis and regurgitation. The two discs of the tricuspid prosthesis were immobilized, half open and half closed.

Proximal isovelocity surface area (PISA) in the evaluation of fixed membranous subaortic stenosis.

The evaluation of the severity of subaortic stenosis is usually expressed by the magnitude of the subvalvular gradient. Calculation of the membrane orifice area noninvasively is difficult by the standard means. We present a patient in whom the area was calculated using the proximal isovelocity surface area (PISA) method.

How useful is hand-carried bedside echocardiography in critically ill patients?

Objectives: The study compared a hand-carried echocardiography (HC) device with standard echocardiography (SE) in critically ill patients.

Background: Recently, small HC devices have been introduced, and early reports showed a good correlation with SE.

Methods: We used HC (SonoSite, Bothell, Washington) echocardiography to evaluate critically ill patients, and we compared the results with SE obtained with state-of-the-art equipment (Sonos 5500, Hewlett-Packard, Andover, Massachusetts).

Valve strands are strongly associated with systemic embolization: a transesophageal echocardiographic study.

Objectives: We attempted to determine the prevalence of strands on native and prosthetic valves, as detected by transesophageal echocardiography, and to assess the relative risk for systemic emboli associated with these strands.

Background: Fine threadlike strands, seen on native and prosthetic valves by transesophageal echocardiography, have been implicated in systemic embolization.

Methods: During a 2-year period, 1,559 patients underwent transesophageal echocardiography at our center.