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Biomedical subjects

A Benchimol

Publications and source records attributed to A Benchimol.

At least 19 recordsLinked to original sources

[Occlusive spasm of a coronary artery not treated during angioplasty. Apropos of a case].

The authors report the case of a patient who, during percutaneous transluminal angioplasty of the circumflex artery, developed sudden occlusion of the anterior interventricular artery without stenosis and not touched by the operator. The fact that this occlusion was completely reversible after an intra-coronary injection of nitroglycerin suggests that this was due to spasm. This case suggests the possibility of consequences of angioplasty at a point distant from the dilated site. The authors use this case and a review of the literature to discuss the pathophysiological mechanisms which could be responsible for such consequences.

Angioplasty, Balloon, Coronary

Two-dimensional echocardiographic recognition of an aortic intimal flap prolapsing into the left ventricular outflow tract.

A 59 year old man presented with dyspnea and a new murmur of aortic regurgitation. Two-dimensional echocardiography demonstrated a to and fro motion of the intimal flap as it prolapsed into the left ventricle and was thrust into the aorta during diastole and systole, respectively. At surgery, the echocardiographic and angiographic findings were confirmed and a proximal aortic dissection was identified. Prolapse of an intimal flap from the aorta into the left ventricular outflow tract represents a new two-dimensional echocardiographic sign of aortic dissection.

Aortic Dissection

Cardiac rupture.

Explore the source record for details and available documents.

Cardiac Catheterization

Phonocardiographic findings in patients with normally functioning Ionescu-Shiley prostheses.

Phonocardiographic findings are reported in 19 patients with normally functioning Ionescu-Shiley prostheses in the mitral or aortic position. Opening clicks were recorded in all 8 patients with mitral prostheses at a mean second heart sound (A2) to opening click interval of 94 ms. In 9 subjects, apical systolic murmurs were found. All 11 patients with the prosthesis in the aortic position had systolic ejection murmurs. Opening clicks were observed in 8 patients with a mean Q wave to opening click interval of 125 ms; closing clicks were found in 9 of 11. No diastolic murmurs occurred in this group. These acoustic characteristics serve as a reference source for the noninvasive evaluation of the bovine pericardial prosthesis.

Adult

M-Mode and 2-dimensional echocardiographic characteristics of the Ionescu-Shiley valve in the mitral and aortic positions.

Using M-mode and 2-dimensional (2-D) echocardiography, ultrasonic features of the Ionescu-Shiley valve were characterized. A number 23 prosthesis was placed in a saline-filled chamber and subjected to pulsatile flow. Production of a linear tear at the base of a cusp resulted in coarse fluttering in the open position, and there was a reduction in the anterior cusp slope. Partial detachment of a cusp from its stent produced high-amplitude low-frequency fluttering during ejection. Alteration of transducer position eliminated the abnormal echoes. Fourteen patients with aortic and 11 with mitral prostheses were studied. There was a close approximation of echographically determined values for the bare stent internal diameter, cusp excursion, and valve orifice diameter compared with the manufacturer's specifications. Random punctiform echoes were noted when the cusps opened. Cusp echoes were superimposed on stent echoes in 21% of patients, and a third cusp was detected in 29%. Two-dimensional echocardiograms of good quality were recorded in the vast majority of subjects. Cusp echoes were smooth and had a consistent motion in both the short and longitudinal axis. Multiple transducer positions were required to delineate prosthetic components with optimal clarity. It is concluded that (1) M-mode and 2-D echocardiography is useful in assessing Ionescu-Shiley valve function, (2) in vitro valve tears or detachment produces characteristic cusp fluttering, (3) careful attention to transducer positions is necessary to record high-quality valve images, and (4) these findings represent a data base for the longitudinal follow-up study of patients with the Ionescu-Shiley valve.

Adult

Non-invasive diagnosis of a free-floating left atrial thrombus with emphasis on two-dimensional echocardiographic features.

Two-dimensional echocardiography permitted identification of a large free-floating left atrial thrombus in a patient with mitral stenosis. A specific pattern of motion afforded its recognition and differentiation from mural left atrial thrombosis and tumors. Phonocardiographic tracings revealed a non-ejection systolic click and opening snap. A gated blood pool scintigram disclosed a left atrial filling defect. Subsequent left atrial angiography and left atriotomy confirmed the non-invasive findings.

Auscultation