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Biomedical subjects

B Soto

Publications and source records attributed to B Soto.

At least 91 records · Page 5Linked to original sources
PubMed1981

Cineangiography in the diagnosis of aortic dissection.

To assess the ability of biplane cineangiography in the diagnostic evaluation of acute dissection of the aorta, 20 patients with acute dissection were studied within 24 hours of surgery or autopsy, or both. Biplane large film aortic angiography was performed in 11 patients (Group I) and biplane aortic cineangiography in 9 (Group II). The morphology of the aortic valve was defined precisely in 5 (50 percent) of 10 patients in Group I and in all 9 patients (100 percent) in Group II (p less than 0.02). Aortic regurgitation weas diagnosed in all patients in both groups in whom it was present (p = not significant). Intimal tears were localized in 5 (50 percent) of 10 patients in Group I and in 8 (89 percent) of 9 in Group II (p less than 0.07). Intimal flaps were not identified angiographically in three patients in Group I and were identified in four patients (100 percent) in Group II (p less than 0.01). The presence of retrograde dissection was established in three (38 percent) of eight patients in Group I and in four (100 percent) of four patients in Group II (p less than 0.05). There was no difference in the ability to identify a nonclotted false lumen between cine and large film angiography. It is concluded that in addition to improved diagnostic capabilities, technical advantages make cineangiography a good alternative to large film angiography in the diagnostic evaluation of patients with acute dissection of the aorta.

Adult↗
PubMed1981

Significance of the caudal left-anterior-oblique view in analyzing the left main coronary artery and its major branches.

The authors describe the value of the caudal left-anterior-oblique view in visualizing the following arteries: left main coronary, proximal circumflex, early-arising first marginal, proximal left anterior descending, first diagonal, and anomalous septal perforators from the circumflex system. The technique involves movement of the parallelogram (x-ray tube--image intensifier combination) to the left 55-65 degrees and caudal angulation of 15-20 degrees. To promote additional profiling of the left coronary system, imaging is performed after full expiration. In our series of 100 patients, this view is indispensable in determining significant pathology in the arteries of the proximal left coronary system.

Angiocardiography↗
PubMed1981

Angiographic anatomy of the normal heart through axial angiography.

We sectioned a series of hearts in a manner similar to that seen on angiographic axial views. A correlation with normal angiograms to identify the anatomic components of the four cardiac chambers showed that the components of the normal cardiac anatomy can be identified accurately through axial angiography in a manner not show previously.

Heart↗
PubMed1981

Tetralogy of Fallot: an angiographic-pathologic correlative study.

The anatomic abnormalities observed by cineangiographic axial techniques of 12 patients with tetralogy of Fallot were correlated with anatomic details noted at necropsy. Right ventricular angiograms made in the right anterior oblique view best demonstrated the severity and type of infundibular obstruction and also permitted differentiation of the perimembranous, infundibular muscular and subarterial types of ventricular septal defects. The degree of aortic overriding was best displayed in the long-axis view. Comparison of the intracardiac anatomy of each postmortem specimen with the respective premortem cineangiogram has provided further clarification of the angiographic anatomy displayed by these axial techniques.

Aortography↗
PubMed1981

Congenital heart malformations: sequential angiographic analysis.

A segmental angiographic analysis of congenital heart malformations has been developed with the intention of making evaluation of complex congenital heart anomalies as comprehensive as possible. Each vascular and cardiac segment is analyzed sequentially, considering morphology, connections, and relations. Additional associated cardiovascular abnormalities such as shunts, stenoses, hypoplasias, and atresias are also considered. Information analyzed and presented in this way has more immediate anatomic and physiologic meaning than ambiguous terms, often with obscure embryologic implications. Disagreements regarding definitions and nomenclature will continue; however, a logical framework that allows clear communication among cardiologists, surgeons, and angiographers is absolutely necessary and is provided by the orderly analysis presented here.

Coronary Vessel Anomalies↗
PubMed1980

Hemodynamic evaluation of patients with combined mitral and aortic prostheses.

Complete hemodynamic evaluation of patients with combined aortic and mitral mechanical valve prostheses presents a difficult technical problem. Yet such patients with cardiac symptoms postoperatively often require this evaluation to determine the diagnosis and the advisability of reoperation. A 4 year experience with 22 patients requiring such evaluation is reviewed. Eight patients (36 percent) required reoperation for malfunction of the prosthesis. Four (18 percent) had major complications of the cardiac catheterization study, but no fatalities or residual permanent defects resulted. In 17 cases transthoracic left ventricular needle entry was used. A standardized procedure of this type for both pressure measurement and angiographic studies has evolved, providing reasonable efficiency and a relative degree of safety. The patient is positioned in the right anterior oblique position for optimal needle entry into the left ventricular apex and angiographic visualization of mitral prosthetic incompetence and the myocardial contractile pattern. A 16 gauge needle with side holes but no end hole allows ventriculography to be performed after chamber entry using the prostheses as reference points under fluoroscopic guidance. Retrograde catheterization of the aortic prosthesis, transseptal left atrial catheterization with anterograde crossing of the mitral prosthesis and transapical pressure measurement with a similar needle, combined with quantitative left atrial angiography, are alternative choices for study.

Adult↗
PubMed1980

Classification of ventricular septal defects.

A classification with clinical significance is proposed for ventricular septal defect based on the study of 220 hearts with defects of the ventricular septum. All had atrioventricular and ventriculoarterial concordance with normal relations of cardiac structure. For the purpose of classification, the ventricular septum was considered as possessing muscular and membranous portions, the muscular septum itself being divided into inlet, trabecular, and outlet (or infundibular) components. Defects were observed in the area of the membranous septum, termed perimembranous defects; within the muscular septum, termed muscular defects; or in the area of septum subjacent to the arterial valves, termed subarterial infundibular defects. Perimembranous defects were found extending either into the inlet, trabecular, or infundibular septa. Muscular defects were found in or between the inlet septum, trabecular septum, or infundibular septum. Review of the angiograms showed that the classification was easy to use in the catheterisation laboratory, and our observations suggest that the precision thus obtained has considerable surgical significance.

Heart Septal Defects, Ventricular↗
PubMed1979

Nonobstructive coarctation.

Roentgenographic studies, including plain chest roentgenography, thoracic aortography, and coronary angiography, were performed in seven adult patients with nonobstructive coarctation, a congenital deformity of the upper thoracic aorta. The chest roentgenographic findings were compared with those of ten patients with obstructive coarctation studied during the same period. A great similarity was found in the morphology and associated lesions of these two conditions, which supports the idea that nonobstructive and obstructive coarctation are stages of the same disease. Patients with nonobstructive coarctation had a more prominent aortic arch, and the indentation in the thoracic aorta was higher than in patients with obstructive coarctation. In addition, patients with nonobstructive coarctation had no rib notching on plain chest roentgenograms. Angiographic evaluation in patients with nonobstructive disease demonstrated the anatomic lesion, the absence of collateral circulation, and the commonly associated anomalies of the aortic valve.

Adult↗
PubMed1979

Angiographic study of univentricular heart of right ventricular type.

An angiographic analysis of 10 cases of univentricular heart of the right ventricular type is reported. This congenital malformation is characterized by a large chamber with right ventricular morphology that receives both atrioventricular valves, and a second, smaller chamber, a trabecular pouch, with left ventricular morphology. These chambers are separated by a posterior septum but are connected by an inlet septal defect. The angiographic studies were done using the angled angiographic techniques in three patients and the standard frontal and lateral angiographic views in seven cases. The atrial situs in seven patients was solitus, in one inversus, and in two it was ambiguus with left isomerism. In seven patients the usually large right ventricular chamber received two atrioventricular valves and in four patients, one atrioventricular valve was straddling. Three patients had atresia of one atrioventricular valve. The trabecular pouch was small in seven patients but relatively large in three. In six patients the trabecular pouch was located posterior and to the left of the right ventricular chamber and in four anterior and to the right. Double outlet right ventricle was present in all cases. The aorta arose anteriorly to the pulmonary artery in nine patients and posteriorly in one. An autopsy was performed in one case and its correlation with the angiographic findings was remarkable. The angiographic demonstration of the anatomicaly details of this entity and its associated anomalies was facilitated by angled angiography.

Adult↗
PubMed1979

Preoperative prediction from cineangiograms of postrepair right ventricular pressure in tetralogy of Fallot.

To aid preoperative decision-making, we have related the ratio of postrepair peak pressure in the right and left ventricles (PRV/LV) to preoperative cineangiographic measurements in a retrospective study of 135 patients undergoing complete repair of tetralogy of Fallot or tetralogy of Fallot with pulmonary atresia. Postrepair PRV/LV was related to the preoperative diameter of right (DRPA) and left (DLPA) pulmonary arteries normalized to the descending thoracic aorta (DescThAo) in patients undergoing repair with transannular patching or a valved external conduit by the dquation: PRV/LV = 0.4840/(DRPA/DescThAO + DLPA/DesThAo) + 0.2007. Stenosis of the right pulmonary artery orifice and pulmonary artery arborization abnormalities incrementally increased postrepair PRV/LV. When a transannular patch was not used in classical tetralogy of Fallot, an increment of postrepair PRV/LV usually resulted, depending upon the size of the "anulus" measured intraoperatively: Incremental PRV/LV = 0.09437 . exp(-0.6344 . Z) where Z is a normalized expression in circumference terms of the diameter of the pulmonary arterial outflow tract (DPAOT) measured intraoperatively after infundibular dissection and valvotomy. DPAOT is itself related to the cineangiographically measured pulmonary valve anulus diameter (DPVA): DPAOT = 3.357 . DPVA0.5789 . BSA0.1551. In toto, these relations allow postrepair PRV/LV without transannular patching to be estimated from preoperative cineangiographic measurements. This allows preoperative predictiom in classical tetralogy of Fallot of the need for transannular patching, and in infants this can determine the choice between primary one-stage repair and two-stage repair. Prediction of postrepair PRV/LV when transannular patching or an external conduit is planned allows identification of patients in whom right and left pulmonary arteries are too small for safe complete repair, and in them an initial palliative operation should be done to enlarge the arteries.

Adolescent↗
PubMed1977

Chest pain and bilateral atrioventricular valve prolapse with normal coronary arteries in isolated corrected transposition of the great vessels. Clinical, angiographic and metabolic features.

A man evaluated for disabling chest pain was found to have isolated anatomically corrected transposition of the great vessels. Angiography demonstrated right and left atrioventricular (A-V) valve prolapse and normal coronary arteries. Atrial pacing produced chest pain, ischemic electrocardiographic changes, abnormal myocardial lactate metabolism and marked elevation of the left ventricular end-diastolic pressure; all of these changes returned to normal on termination of pacing. The association of corrected transposition and bilateral A-V valve prolapse and the possible causes of myocardial ischemia in this patient are discussed.

Fatty Acids, Nonesterified↗
PubMed1977

Axial cineangiography in congenital heart disease. Section II. Specific lesions.

The value of axial cineangiography in several forms of congenital heart disease serves as an illustrated supplement to Section I. These techniques visualize defects in the entire ventricular and atrial septum. In persistent atrioventricular (A-V) canal, it is possible to visualize all parts of both septa, status of the A-V valves (two valves versus a common A-V valve), and if a common A-V valve, its degree of override. In tetralogy of Fallot, the bifurcation of the pulmonary trunk, entire ventricular septum and coronary arteries are vividly shown. The presence of true and confluent pulmonary arteries versus systemic or bronchial arteries in pseudotruncus is clearcut. In double outlet right ventricle or in transpositions with or without double outlet right ventricle, the mitral valve-semilunar valve relationships, the left ventricular outflow tract, subpulmonary region and a straddling tricuspid valve are well demonstrated. In asymmetric septal hypertrophy, biventricular angiography may be circumvented.

Cardiomyopathy, Hypertrophic↗