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Biomedical subjects

G M Ziady

Publications and source records attributed to G M Ziady.

26 records · Page 2Linked to original sources
PubMedDate not supplied

Incomplete ventricular septal tear after blunt chest trauma: medical management with serial echocardiographic follow-up.

Incomplete ventricular septal tears are uncommon or probably underreported cardiac lesions caused by blunt chest trauma. This report describes two cases of incomplete ventricular septal tears that were not suspected clinically. Transthoracic and transesophageal echocardiography provided the diagnostic information in both of these cases. Despite associated valvular lesions, the patients' stable in-hospital course lead to the decision to treat them medically with no specific treatment to the incomplete ventricular septal tears. Accordingly, these two cases were observed for a mean period of 1.5 years with serial echocardiographic studies to track the natural history of these lesions. During the follow-up period, both of these cases did not manifest any changes in the extent of ventricular septal tear, septal structure, or any left-to-right shunting through the tear. There were no significant changes in left ventricular size, shape, or systolic function. Thus echocardiographic imaging proved to be useful both in initial diagnosis and follow-up.

Adolescent↗
PubMedDate not supplied

A double-blind trial of glycopyrrolate for transesophageal echocardiography.

Glycopyrrolate is an anticholinergic agent used to dry oral secretions and has been advocated for routine use with transesophageal echocardiography (TEE). To evaluate the safety and efficacy of glycopyrrolate for this unique application, a prospective double-blind placebo-controlled study of glycopyrrolate was performed in 61 patients who were awake while undergoing TEE. Thirty patients were randomized to the standard dose of glycopyrrolate (0.2 mg intravenously), and 31 patients received 1 ml of saline solution as placebo. Intravenous midazolam was used for sedation in all but one patient. Heart rate, electrocardiogram, blood pressure, and oxygen saturation were continuously monitored before, during, and after TEE. The patients scored their comfort immediately after TEE and were interviewed at 24 hours for side effects. The operator scored the ease of performing the TEE. No complications occurred in either group. Changes in vital signs and oxygen saturation were similar in both groups. The operator ease and patient comfort was similar in both groups. A significantly higher incidence of the following side effects was observed at 24 hours in patients who received glycopyrrolate versus those who received placebo: sore throat, 63% versus 19%; dry mouth, 43% versus 6%; and urinary retention, 16% versus 0% (p < 0.05 for all). No benefit from glycopyrrolate was noted in operator ease or patient comfort. In conclusion, glycopyrrolate is not recommended for routine use when performing TEE on patients who are awake.

Adult↗
PubMedDate not supplied

Early diagnosis and follow-up by echocardiography of acquired cor triatriatum after orthotopic heart transplantation.

Acquired cor triatriatum in a heart transplant recipient, secondary to a prominent left atrial suture line and torsion of the atria, was diagnosed immediately after cardiopulmonary bypass by transesophageal echocardiography. The patient was followed with serial echocardiograms and right heart catheterizations, showing resolution of the obstruction.

Cardiac Catheterization↗
PubMedDate not supplied

Assessment of biventricular cardiac function in patients with a Novacor left ventricular assist device.

Novacor left ventricular assist devices were implanted in 10 patients. We used blood-pool radionuclide angiography and echocardiography to evaluate the response of the left and right ventricle to the left ventricular assist. Radionuclide angiography was done before and after implantation of the Novacor left ventricular assist devices in all cases. All patients had diffuse left ventricular enlargement; the mean left ventricular ejection fraction before Novacor left ventricular assist device implantation was 17% +/- 7%. After implantation of the Novacor left ventricular assist devices the left ventricular ejection fraction improved to 47% +/- 19%, with the pump on a 1:1 assist ratio (p < 0.005). The right ventricular ejection fraction before the Novacor left ventricular assist device implantation was 21%, which improved to 32% with the Novacor left ventricular assist devices (p < 0.01). Doppler echocardiography was carried out in nine patients with the left ventricular assist devices. In five patients the aortic valve remained closed throughout systole. In four patients partial aortic valve opening was noted. At an assist ratio of 1:3, complete opening of the aortic valve was noted in all cases (n = 9); the left ventricular ejection fraction decreased to 31%. We conclude that the Novacor left ventricular assist device substantially improves both right ventricular ejection fraction and left ventricular ejection fraction, although the aortic valve typically remains closed.

Echocardiography↗