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M A García-Fernandez

Publications and source records attributed to M A García-Fernandez.

5 recordsLinked to original sources
PubMed2000

Echocardiographic features of left atrial dissection.

AIMS: To study left atrial dissection, a rare complication of mitral valve replacement. METHODS AND RESULTS: From our hospital database of 5497 transoesophageal echocardiograms, we analysed 524 echocardiograms performed on 478 patients with mitral valve prosthesis. We found four patients (0.84%) with left atrial dissection diagnosed by transoesophageal echocardiography that visualized the left atrial dissection: in three patients the diagnosis was confirmed intraoperatively. Three patients had previously had replacements of the mitral valve. Left atrial dissection was a severe complication: one patient died and the two patients successfully operated on had paraprosthetic regurgitation. CONCLUSION: Transoesophageal echocardiography is the first choice for diagnosis of left atrial dissection, a rare complication of mitral valve replacement with an acute/subacute clinical course. Previous mitral valve replacement seems to be the main risk factor to develop left atrial dissection.

Aged↗
PubMed1992

[Echocardiographic quantification of mitral regurgitation. Comparative study with transthoracic and transesophageal Doppler color echocardiography].

The quantification of mitral regurgitation by means of colour coded Doppler echocardiography still is a controversial issue. A prospective study on 86 consecutive patients with mitral regurgitation diagnosis was carried out by means of conventional transthoracic colour coded Doppler echocardiography in order to make a comparative study with results obtained by means of transoesophageal colour coded Doppler echocardiography. A systematic measurement of the following parameters was carried out in each patient: Colour coded area or mitral regurgitation jet, auricular depth of mitral regurgitation jet, severity degree of mitral regurgitation, left auricular area, mitral regurgitation ratio and transthoracic crossection plan of largest regurgitation area. Both echocardiographic techniques had the first three parameters in common. The mitral regurgitation area by transthoracic echocardiography was 370 +/- 41 mm2 and by transoesophagial technique 558 +/- 43 mm2 (p less than or equal to 0.001 - r = 0.71). The depth of mitral regurgitation by transthoracic path was 31 +/- 2.7 mm and by transoesophageal path 37 +/- 25 mm (p less than or equal to 0.01 - r = 0.74). The existing correlation between the mitral regurgitation area obtained by both techniques improved (r = 0.84) when a four camera apical transthoracic plan was used and worsened (r = 0.45) when the longitudinal parasternal path was used. We came to the conclusion that the valorization of mitral regurgitation made by both techniques is not accurately comparable, existing undervaluation in transthoracic echocardiography. The discrepancies between the two techniques are more patent and statistically more significant when longitudinal parasternal plan is used for transthoracic quantification of severity degree of mitral regurgitation.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1990

Two dimensional echocardiography and Doppler in the right ventricular infarction.

Two dimensional and Doppler echocardiography provide reliable and valuable information in order to evaluate right ventricular function and associated complications in patients with right ventricular infarction. Right ventricular function in right ventricular infarction. There are a number of indirect findings that may support the noninvasive diagnosis of ischemic right ventricular dysfunction and right ventricular infarction: 1. Right ventricular dilatation: A right ventricular diastolic dimension greater than 8 mm/m2 is highly indicative of ischemic right ventricular dysfunction, provided that other causes of right ventricular dilatation, but the sensitivity of this findings is low (50%), the same is true for a RVDD/LVDD ratio greater than 0.63. 2. Right ventricular contraction abnormalities: Wall motion abnormalities constitute the most sensitive and specific echocardiographic findings in the right ventricular infarction. The most common site of involvement is the posterior wall, over 32 patients with right ventricular infarction, 60% present abnormalities confined to the posterior segment; in 30% there is also abnormal contraction of the lateral wall and 10% of the cases present asyneresys of the anterior, lateral and posterior segments. Those patients with the most severe right ventricular dysfunction presented a higher number of right ventricular wall segments with abnormal wall motion. Abnormalities in right ventricular contraction may still be present after evolution and normalization of the hemodynamic data of right ventricular infarction. These findings suggest that wall motion abnormalities can be more sensitive than the hemodynamic in detecting right ventricular infarction. 3. Paradoxical septal motion: Is a common findings after right ventricular infarction and has been attributed to volume overload and alterations in right ventricular compliance, near of 50% present abnormalities of septal motion and those patients with most severe ventricular dysfunction presented most frequently abnormal septal motion. Right ventricular infarction complications. Right ventricular aneurysm: In a series of 50 consecutive patients surviving an episode of right ventricular infarction, we could only find five (10%) with a true ventricular aneurysm. The segments included always the apex and in two cases a thrombus was identified inside its cavity. Functional right ventricular aneurysm may be found in a high percentage (10/50.20%) of patients with right ventricular infarction. Right ventricular thrombi: The identification of thrombi in the right heart is more difficult than in the left ventricle, due to the trabeculation of the right ventricular wall. We could only find 6 cases, in a series of 50 patients studied by two dimensional echocardiography. In all of the cases the ventricular wall adjacent to the thrombus presents contraction abnormalities.(ABSTRACT TRUNCATED AT 400 WORDS)

Coronary Circulation↗