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Biomedical subjects

G Satomi

Publications and source records attributed to G Satomi.

At least 73 records · Page 4Linked to original sources
PubMed1985

A case of absent right superior vena cava with persistent left superior vena cava: cross-sectional echocardiographic diagnosis.

We report a case of absence of the right superior vena cava. Hitherto, the findings in this condition have only been obtained using invasive methods; this report is the first in which the diagnosis was made by means of echocardiography. The findings include a markedly enlarged coronary sinus draining into the right atrium and a specific finding of contrast echocardiography in which contrast material injected into the right antecubital vein can be seen in the enlarged coronary sinus. The contrast echo flows into the right atrium from the coronary sinus only. The size of the coronary sinus was far beyond the range (91 +/- 38 mm2/m2) in patients with persistent left superior vena cava with the presence of the right superior vena cava.

Adolescent↗
PubMed1985

[Diagnostic evaluations of 36 surgical patients confirmed by noninvasive technique, mainly by two-dimensional echocardiography].

In 1983, 290 patients with congenital heart disease (CHD) underwent surgery at our institute. Among them, 36 (12%) had no preoperative catheterization or angiography. These 36 patients were categorized as group I consisting of 12 patients less than two months of age and group II consisting of 18 patients more than one year of age. The diagnosis was accurate in 34 of the 36 patients (94%). Assessment by two-dimensional echocardiography (2-DE) was incomplete for two patients. A secundum atrial septal defect in one patient diagnosed by 2-DE, proved at surgery to be a sinus venosus type atrial septal defect with partial anomalous pulmonary venous drainage. Another patient was diagnosed as having tetralogy of Fallot with the absent pulmonary valve by 2-DE, but anomalous origin of the right pulmonary artery from the ascending aorta was also found at surgery. There were 25 operations in patients less than two months of age, and 12 (48%) of them had surgery without catheterization (Group I). Most patients in Group I were less than two weeks of age (nine patients) and six of these were operated without catheterization (pure pulmonary atresia: 2, total anomalous pulmonary venous drainage: 2, interruption of the aorta: 1, tetralogy of Fallot with absent pulmonary valve: 1). Another two cases had surgery after only radial artery retrograde aortic arch visualization, then, preoperative intracardiac catheterization was avoided in eight (89%) of the nine patients. Atrial septal defect (ASD) and patent ductus arteriosus (PDA) patients, 25% and 69% of the cases, respectively, were operated on without catheterization. In conclusion, we can better maintain the general condition of critically-ill neonates and infants in surgery, when prompt and accurate 2-DE diagnoses are made for typical cases without catheterization and angiography. In older children of uncomplicated ASD or PDA with typical physical findings, we can avoid catheterization before surgery. If, however, information is insufficient for deciding surgery, we should carry out invasive examinations without hesitation.

Adolescent↗
PubMed1984

Systematic visualization of coronary arteries by two-dimensional echocardiography in children and infants: evaluation in Kawasaki's disease and coronary arteriovenous fistulas.

We describe in our report a systematic approach for visualizing in detail coronary artery anatomy by two-dimensional echocardiography (2DE). The approach provides longitudinal and transverse images of the proximal coronaries, as well as transverse images of the anterior descending and right coronary artery tree. The method is delineated by showing certain cases of Kawasaki's disease (MCLS) and coronary arterial fistula. Using these multiple echo planes, the diagnostic accuracy was improved for both right and left coronary arteries.

Adolescent↗
PubMed1984

Evaluation of tricuspid regurgitation by blood flow pattern in the hepatic vein using pulsed Doppler technique.

Evaluation of tricuspid regurgitation (TR) was attempted by observing the blood flow pattern in the hepatic vein (HV), inferior vena cava dimension (IVCD), and hepatic vein dimension (HVD), with the use of a combined system of pulsed Doppler technique and two-dimensional echocardiography in 60 patients with valvular heart disease. For comparison, all patients underwent right ventriculography, by which TR was classified as mild, moderate, or severe. IVCD and HVD of the group with severe TR were significantly larger than those of the other groups (p less than 0.005). Several types of abnormal blood flow patterns in the HV were demonstrated in patients with atrial fibrillation. By these flow patterns, the severe or moderate TR groups could be differentiated from the mild TR group, because 21 of the 26 patients (81%) in the former group showed reverse hepatic flow during systole. Also, the Doppler shifts from baseline in the sound spectrogram correlated well with right atrial pressure (RAP) and right ventricular end-diastolic pressure (RVEDP) (r = -0.72, -0.64, p less than 0.001, respectively). This method is useful for rapidly evaluating considerable TR and for estimating RAP and RVEDP noninvasively.

Adult↗
PubMed1984

Dynamics of right heart flow in patients after Fontan procedure.

In seven patients who underwent Fontan procedures but in whom no valves were inserted, dynamics of right heart flow were evaluated with the use of a catheter-tipped velocity transducer, pulsed Doppler echocardiography, and angiocardiography. Right atrial (RA) contraction caused a forward flow to the pulmonary artery (PA) and a backward flow to the inferior vena cava (IVC). Backward flow to the superior vena cava (SVC) was minimal. As the right atrium relaxed, a rapid forward flow occurred at the IVC and SVC that filled the atrium and a small amount of pulmonary regurgitant flow was observed. Subsequently, a forward flow was observed at the IVC, SVC, and PA during RA diastole. Angiographically determined RA stroke volume (SV) was less than 40% of the left ventricular (LV) SV in three patients in whom the postoperative increase in atrial "a" wave pressure (delta p) was greater than 8 mm Hg, while it was similar to or greater than LVSV in four patients in whom delta p was 6 mm Hg or less. In all patients LV end-diastolic volume was 107 +/- 27(SD)% of normal but LV ejection fraction was 0.53 +/- 0.07, resulting in the reduced cardiac output (2.8 +/- 0.7 l/min/m2). There was no correlation between the RASV or RA ejection fraction and cardiac output. These data show that the RA contraction causes a forward flow to the PA and that pulmonary regurgitation is not significant after Fontan procedure even when valves are not inserted. Also, the postoperative increase in the RA afterload may depress RA function.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Pulmonary arteriography through patent ductus arteriosus with preformed catheters.

Selective pulmonary arteriography was performed successfully with new preformed catheters in eight consecutive patients with pulmonary atresia or severe stenosis and patent ductus arteriosus. The catheters were inserted percutaneously into the femoral artery and passed into the patent ductus arteriosus very easily within a few minutes. Pulmonary arteriography was performed with biplane cineangiography. All eight patients showed either stenosis or secondary atresia in the central pulmonary artery. The obstructive lesions occurred at the junction of either a patent ductus arteriosus or a surgically anastomosed subclavian artery.

Adult↗
PubMed1983

Clinical and echocardiographic features of pulmonary valve endocarditis.

We studied the clinical and echocardiographic features of eight patients with infective pulmonary valve endocarditis. In two patients, the vegetation was limited to the pulmonary valve; in the six other patients, infective lesions were also present on the mitral or aortic valves. None of the patients were addicted to narcotics. Seven of the eight patients had underlying congenital heart disease. In six patients the organism responsible for the infective endocarditis was Streptococcus viridans. Two-dimensional echocardiography performed using a wide-angle sector scanner was more useful than M-mode echocardiography for evaluating patients with pulmonary valve endocarditis.

Adolescent↗
PubMed1983

Two-dimensional echocardiographic detection of pulmonary venous channel stenosis after Senning's operation.

Stenosis of the common pulmonary venous (PV) channel after Senning's operation for complete transposition of the great arteries is a serious problem, and a method for noninvasive diagnosis is highly desirable. Therefore, our purpose was to devise a method to diagnose PV channel stenosis noninvasively. The newly created common PV channels were measured and the short-axis views of the left ventricle were observed by means of two-dimensional echocardiography in 16 patients who had undergone Senning's procedure. In seven patients we used the original procedure and in nine patients we used a modified procedure with a pedicled pericardial patch. The shape of the left ventricle became round abruptly when the width of the PV channel decreased below a critical value (a range of 6 to 9 mm). Three patients with a relatively round-shaped left ventricle and a narrow PV channel (below 9 mm) were all confirmed to have PV channel stenosis at reoperation. All of the patients with a wide PV channel (above 10 mm) and a flat-shaped left ventricle were in good condition both clinically and as determined from the catheterization data. After the operation, patients who had tricuspid regurgitation, pulmonary vascular obstruction, or residual left ventricular outflow tract stenosis had a relatively round-shaped left ventricle even though the PV channel was wide enough (above 10 mm). Measurement of the PV channel confirmed the effects of these conditions. Correct diagnosis of PV channel stenosis can therefore be made by observing the shape of the left ventricle and by measuring the PV channel.

Child↗
PubMed1983

Two-dimensional echocardiographic classification of persistent truncus arteriosus.

Three cases with persistent truncus arteriosus, a 1-year-old boy with a type I, an 8-month-old girl with a type II, and a 5-year-old girl with type II, all confirmed by surgery, were studied by two-dimensional echocardiography (2-DE). The 2-DE findings corresponded well with the actual anatomy as determined by direct visualization as well as angiogram. A "piling-up" method using 2-DE to reconstruct three-dimensional anatomical images is useful in making the correct diagnosis of persistent truncus arteriosus as well as typing this anomaly noninvasively.

Angiography↗
PubMed1983

[Hepatic vein blood flow pattern measured by Doppler echocardiography as an evaluation of tricuspid valve insufficiency].

Evaluation of tricuspid regurgitation was attempted by analyzing the blood flow pattern in the hepatic vein using a combined system of a pulsed Doppler technique and two-dimensional echocardiography. The Doppler incident angle to the hepatic vein from the subcostal approach was approximately 0 degrees to 30 degrees, and the Doppler output was easily recognized as a narrow frequency-band pattern on the sound spectrogram. The study population consisted of 60 patients with valvular heart disease and 17 healthy subjects. Inferior vena cava dimension (IVCD), hepatic vein dimension (HVD) and the blood flow pattern in the hepatic vein were compared with the severity (negative, mild, moderate and severe) of tricuspid regurgitation (TR) assessed by right ventriculography and with right atrial and ventricular pressures. The following conclusions were derived from the study: IVCD and HVD in a group of TR severe were significantly larger than those of the other groups. The normal flow pattern of the hepatic vein was biphasic with a systolic flow greater than a diastolic flow. In cases of valvular heart disease with atrial fibrillation, three types of abnormal blood flow patterns were demonstrated; Type 1 had a slower systolic flow than a diastolic flow. Type 2 had no flow signal during systole, and had only a diastolic flow. Type 3 had a reversed systolic flow with several variations. By this hepatic flow patterns, it was possible to differentiate the TR of severe and moderate groups from the TR of mild group, because 81% of the former groups showed a Type 3 of a flow pattern. The Doppler shifts from the base line on the sound spectrogram were well correlated with right atrial pressure and right ventricular end-diastolic pressure (r = -0.72 and -0.64, respectively). The early changes of the hepatic blood flow pattern after operation were due to the improvement of TR by tricuspid annuloplasty, and also seemed to be affected by the postoperative changes of right atrial compliance and contraction.

Adult↗
PubMed1983

[Two-dimensional echocardiographic diagnosis of tetralogy of Fallot with a total conus defect].

Tetralogy of Fallot (TOF) with a total conus defect has some characteristics different from classical TOF in respect to its morphogenesis and clinical features. This anomaly, although rare in Europe, constitutes approximately 10% of all types of TOF in Japan. In this report, we studied 30 cases of TOF with angiographic or surgical documentation in order to investigate two-dimensional echocardiography as a possible mean of detecting a conus defect in TOF. We classified the entire group into three types according to the location of a ventricular septal defect (VSD): subpulmonic VSD (six cases, I), infundibular muscular VSD (11 cases, II) and perimembranous VSD (13 cases, III). A long-axis view along the right ventricular outflow tract rather than a short-axis view at the level of the aortic root was adopted as a useful examination for viewing VSDs. Using the former image, we could observe precisely a VSD just below the pulmonary valve in all six cases of Type I and three of Type II, but none of Type III. Three cases of Type II which had a short infundibular septum of several millimeters in length with surgical confirmation were very similar to cases of Type I. The discontinuity between the interventricular septum and the pulmonary valve was confirmed to be identical with subpulmonic VSD by angiographic and pathological studies. In conclusion, we could differentiate TOF with a total conus defect from the other types of TOF by detecting the echo defect in the septum just below the pulmonary valve with the aid of a long-axis view of the right ventricular outflow defect.

Adolescent↗
PubMed1982

Transarterial pulmonary venous wedge arteriography in pulmonary atresia, ventricular septal defect, and intact atrial septum.

Transarterial pulmonary venous wedge arteriography was performed in four cases of pulmonary atresia (PA), ventricular septal defect (VSD), and intact atrial septum. In two cases, only the left pulmonary artery was visualized by selective injection to the patent ductus arteriosus (PDA) or Blalock-Taussig anastomosis (B-T shunt), and the right pulmonary artery was opacified by transarterial retrograde pulmonary arteriography. In two other cases, with nonfunctioning B-T shunt, the pulmonary artery was not opacified by either aortography nor by injection into the B-T shunt. Transarterial pulmonary vein wedge arteriography visualized a confluent pulmonary artery. Transarterial pulmonary vein wedge arteriography was a useful and safe procedure for opacifying the pulmonary artery that could not be visualized antegradely in VSD, PA, and intact atrial septum.

Adolescent↗
PubMed1982

Detection of mitral ring abscess by two-dimensional echocardiography.

M-mode and two-dimensional echocardiographic features of mitral ring abscess are described. A round, dense echo mass between the posterior mitral leaflet and left ventricular posterior wall was demonstrated in long- and short-axis views of the left ventricle. The diagnosis of mitral ring abscess was confirmed at surgery. The superiority of two-dimensional echocardiography over M-mode echocardiography for evaluating patients with mitral ring abscess is also discussed.

Abscess↗