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Biomedical subjects

Luis Muñoz-Castellanos

Publications and source records attributed to Luis Muñoz-Castellanos.

9 recordsLinked to original sources

Aortic obstruction: anatomy and echocardiography.

Echocardiography is a valuable non-invasive technique for identifying the site and type of aortic obstruction. Knowledge of the morphological details of each type of obstruction is the basis for correct interpretation of the diagnostic images and clinical decisions. This study was undertaken to correlate the echocardiographic images with anatomic specimens of equivalent valvular and supravalvular aortic obstruction. Specimens were part of the collection of the Department of Embryology. Fifty six patients were studied, and forty specimens with aortic obstruction were analyzed. Echocardiographic characteristics: Thirty one (55.3%) patients were women and twenty five (44.7%) men. Valvular aortic obstruction was found in Thirty six patients (64.3 %) and supravalvular aortic obstruction in twenty (35.7%). Anatomic characteristics: Of the forty specimens examined, twenty one (52.5%) had valvular aortic obstruction and nineteen (47.5%) supravalvular aortic obstruction. The anatomoechocardiographic correlation clearly showed that the anatomic findings of the specimen hearts and aortas corresponded to echocardiographic images of valvular and supravalvular aortic obstruction and provided solid corroboration of echocardiographic diagnoses.

Adolescent↗

[Clinical and echocardiographic characteristics of scimitar syndrome].

Seven patients with scimitar syndrome underwent retrospective clinical and echocardiographic examination. The findings were: respiratory infection with dyspnea on moderate exercise in 90%, scimitar sign in four (57%), dextrocardia in five (71%), and interatrial septal defect in five (71%), one of whom had patent ductus arteriosus. Overall, two patients had patent ductus arteriosus: one also had aortic coarctation and the other, a bicuspid aortic valve. Dilation of the right cavities was found in five (71%) and blunt edge in five (71%). In two patients, anomalous drainage was into the right atrium; in another two, into the inferior vena cava; and in three, towards the junction of the right atrium and the inferior vena cava. In three patients, drainage was obstructed. Six patients with cardiac abnormalities proceeded to surgery. Scimitar syndrome is a rare entity. In the large majority of patients (86%), diagnosis and follow-up can be performed echocardiographically.

Aortic Coarctation↗

[Left ventricular outflow tract obstruction in transposition of the great arteries. Correlation between anatomic and echocardiographic findings].

INTRODUCTION AND OBJECTIVES: Left ventricle outflow tract obstructions in transposition of the great arteries are frequent. We report the correlations between two-dimensional echocardiographic and autopsy findings to draw attention to the usefulness of this diagnostic method in the preoperative evaluation of these anomalies. MATERIAL AND METHODS: Of 73 hearts with transposition of great arteries, 26 specimens (38%) with different types of left ventricular outflow tract obstruction were selected to establish the relationship between an anatomical substrate of obstruction and echocardiographic findings in equivalent hearts. Pulsed-wave Doppler studies of velocities at the site of stenosis were done with high-pulse-rate frequency and continuous wave techniques. Eight echocardiographic studies of anatomical specimens and 10 studies in equivalent hearts used for comparison were analyzed to determine correlations. RESULTS: Twenty-eight obstructions were found; the most frequent type being left ventricular outflow tract alteration (77%). The most frequent anomalies were posterior deviation of the infundibular septum, cone-like obstruction, pulmonary valve stenosis and septal hypertrophy, followed by congenital mitral valve anomalies (15 %) and anomalies of the tricuspid valve (8%). Two-dimensional echocardiographic studies revealed different types anatomical obstruction. CONCLUSIONS: We found precise correlations between the anatomical obstruction and its echocardiographic image. Evaluating electrocardiographic findings is important because these findings can affect the choice of surgical treatment or even the decision to use surgery.

Humans↗

Anatomic three-dimensional echocardiographic correlation of bicuspid aortic valve.

This study was undertaken to verify the echocardiographic characteristics of bicuspid aortic valve (AV) using 3-dimensional transesophageal echocardiography by comparing the findings with anatomic examination of autopsy specimens from carriers of this condition. Three-dimensional reconstructions of transesophageal echocardiograms were performed on 14 patients with bicuspid AV, and 20 autopsy specimens of bicuspid AVs were analyzed. Echocardiographic images and autopsy material were correlated. Two variants of bicuspid aorta were identified. In group I the AV had 2 leaflets. This group included 9 (9/14) 3-dimensional echocardiographic studies and 13 (13/20) necropsies. In group II 3 sigmoid leaflets had originally developed and 2 underwent dysplastic fusion, resulting in functionally bicuspid valves. Five (5/14) echocardiographic studies and 7 (7/20) anatomic specimens fell into this category. There was a clear correspondence between anatomic and echocardiographic findings, which leads to the conclusion that 3-dimensional echocardiography is a technique that reliably defines the morphological details of bicuspid AV with the precision of anatomopathologic examination.

Adolescent↗

Ebstein's malformation in the setting of Down's syndrome.

We report a patient with Down's syndrome referred to our Department of Echocardiography for evaluation after an episode of tachyarrhythmia. We diagnosed Ebstein's malformation. As far as we know, this association has been reported previously on only three occasions. We review these previous cases, describe our echocardiographic techniques, and discuss our experience.

Adult↗

[Multiple coronary arteriovenous fistulae. Hazard or predetermination?].

OBJECTIVE: The authors present the clinical cases of three adult patients (49, 53 and 61 year-old), with rheumatic cardiac valvulopathy, and bilateral coronary arteriovenous fistulae draining in the main pulmonary artery. Based on documental investigation, the authors speculate about the predeterminate origin of coronary arteriovenous fistulae. DISCUSSION: At first glance, it seems obvious that congenital cardiopathies occur at random, i.e., embryonic development deviate or stops due to unknown reasons, originating the persistence of lacunar blood spaces prior to the development of coronary arteries cords. There are two factors involved in the genesis of congenital malformations: a genomic preexisting factor and the presence of an environmental precipitating factor, i.e., isolated pulmonary valve atresia or left ventricular hypoplastic syndrome, with mitral and aortic valve stenosis, can predispose development of coronary arteriovenous fistulae. Recently, the question has been raised whether there is a relation of coronary arteries fistulae with: ethnic groups, hereditary gigantism, autoimmune diseases, such as polymyositis, hereditary hemorrhagic telangiectasia, and apical hypertrophic myocardiopathy. CONCLUSION: Coronary arteriovenous fistulae, as well as some congenital cardiopathies, could be due to chromosome alterations or might be related to hereditary diseases, such as hemorrhagic telangiectasia, induced by a disturbed genetic program. Although, there is no concrete evidence that a genetic factor is related to the development of coronary arteriovenous fistulae, there are signs that suggest that such a possibility could be investigated.

Arteriovenous Fistula↗

[Anatomo-echocardiographic correlation of scimitar syndrome in adults].

It is a retrospective study of 7 patients with clinical and echocardiographic assessment, the last was correlated with morphologic features of one equivalent anatomic specimen. The results are: respiratory infections and dyspnea in 90% of cases, scimitar sign in four (57%), interatrial septal defect in five (71%), one of them with patent ductus arteriosus, two (28.6%) only with patent ductus arteriosus. Dextrocardia was found in 5 (71%), dilation of the right cavities in 5 (71%) and blunt edge in 6 (85.7%). In two the colector drained into the right atrium, in one to the junction of the right atrium and inferior vena cava and in the other three into the inferior vena cava through the colector. Six patients with cardiac abnormalities went to surgery. The correlation shows agreement between the echocardiographic image and the anatomic specimen. Scimitar syndrome is a rare entity, which diagnosis and follow up can be performed by echocardiography in a great percentage (86%). The embryologic basis of this syndrome is enhanced.

Adult↗

[Double symmetrical aortic arch. Case report].

We report a six-month-old patient with a double symmetrical aortic arch with tracheal and esophageal obstructive symptoms, who was treated surgically. The diagnostic images consisting of esophagogram, echocardiography and angiography were correlated with an anatomical specimen; the usefulness of the echocardiogram as an initial test is emphasized.

Abnormalities, Multiple↗