Two-dimensional echocardiographic diagnosis of cor triatriatum.
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Biomedical subjects
Publications and source records attributed to A Arvay.
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Two cases of successful surgical removal of left ventricular thrombi are presented. Two-dimensional echocardiography revealed in the first case multiple masses of thrombi in the dilated ventricle consistent with congestive cardiomyopathy and emergency surgery was performed for cerebral embolism. In the second case the thrombus was pedunculated and calcified, a probable sequel of a 17-year old myocardial infarction. The pertinent literature of echocardiographic and surgical aspects of left ventricular thrombi is reviewed.
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A 48-year-old man sustained an inferior myocardial infarction resulting in a left ventricular aneurysm, ventricular septal defect and mitral regurgitation. Aneurysmectomy, closure of the ventricular septal defect, mitral valve replacement and coronary artery bypass were successfully performed.
Surgical treatment in 8 cases of non-tropical eosinophilic endomyocardial diseases with (4 patients) and without (4 patients) eosinophilia is reported. Follow-up results (1 to 4 years) in the 6 survivors, including hemodynamic re-study, were excellent even in patients operated on in the thrombotic stage (3) or with hypereosinophilia (2), or with dominant right ventricular involvement (3). Two-dimensional echocardiography gave the correct description of the pathologic stage and ventricular involvement in 6 of the 8 cases before catheterization.
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From November 1980 to May 1982, 19 patients underwent surgery in this institution for right ventricular outflow tract obstruction. Surgery was performed by placing a bovine pericardial monocusp patch across the pulmonary annulus. There was one hospital death (5.3%), and one late death. The follow-up ranged from 24 to 42 months (mean 32.5 +/- 5.3 months; total, 552 patient months). The condition of the remaining 17 patients is good. Repeat cardiac catheterization was performed in 11 patients and revealed that the right ventricular/pulmonary artery systolic gradient was reduced to 13.7 +/- 9.7 mm Hg postoperatively. Angiography showed a freely mobile, thin valve cusp. No calcification, aneurysmal dilatation, or shrinkage of the monocusp patch was observed. Our experience suggests that right ventricular outflow tract reconstruction with bovine pericardial monocusp patches can be safely performed with good hemodynamic results.
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A case of enormous Chiari's network in a 7-year-old girl is described. It formed a parachute or spinnaker-like sack which moved freely into the pulmonary artery causing mild pulmonic stenosis. The preoperative diagnosis was believed to be myxoma of the right ventricle. The real condition was recognized during the operation. This is the seventh reported case of correction of so-called cor triatriatum dextrum.
The first successful operation of endomyocardial fibrosis in a young woman in Hungary is reported. Left ventricular endocardial thickening had been diagnosed preoperatively using two-dimensional echocardiography.
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