Transesophageal echocardiography through nasal way as a guide to percutaneous closure of patent foramen ovale.

Percutaneous device closure of patent foramen ovale (PFO) has become an effective and safe alternative to medical or surgery treatment. Transesophageal echocardiography (TEE), as commonly used to guide this procedure, has the limitation to require general anesthesia. Recently, intracardiac echocardiography (ICE) with AcuNav probe was used to guide percutaneous PFO closure.

Mitral paraprosthetic leak diagnosed by transesophageal echocardiography through nasal way.

Paraprosthetic leaks are a postoperatively complication recurring with a frequency from 15 to 30%, and mostly in the mitral than in the aortic position. Transthoracic echocardiography can suspect prosthesis valve dysfunction, but for both diagnosis and evaluation of the paraprosthetic dysfunction severity, transesophageal study is required. In this report a mitral paraprosthetic dehiscence was diagnosed using a miniaturized, 10 F, monoplane probe inserted through nasal way.

Noninvasive coronary flow reserve assessed by transthoracic coronary Doppler ultrasound in patients with left anterior descending coronary artery stents.

Noninvasive measurement of coronary flow reserve (CFR) (hyperemic/flow velocity ratio at rest) by transthoracic Doppler echocardiography showed normalization of flow in the left anterior descending (LAD) coronary artery early after stenting. We hypothesized that noninvasive CFR may reveal in-stent restenosis at follow-up. Therefore, we studied 134 patients, 0 to 72 months after successful proximal-middle LAD stenting, and 38 controls.

Measurement of coronary flow reserve in the anterior and posterior descending coronary arteries by transthoracic Doppler ultrasound.

We describe for the first time transthoracic Doppler ultrasound assessment of coronary flow reserve (CFR) in both the posterior descending (PDA) and left anterior descending (LAD) coronary arteries. CFR (hyperemic/resting diastolic flow velocity ratio) was measured by 90-second intravenous adenosine infusion (140 microg/kg/min). Baseline PDA flow was detected in 62 of 81 subjects (76%), and the CFR was measurable in 44 of them (54%) because of adenosine-induced hyperventilation.