P A Tunick

..Thus, there is a protective effect of statin therapy, and no significant benefit of warfarin or antiplatelet drugs on the incidence of stroke and other embolic events in patients with severe thoracic aortic plaque on TEE...

..003). In conclusion, although both techniques are complementary, TEE does identify more high-risk plaques...

..Representative images from these complementary studies are presented. A successful repair of the fistula was subsequently accomplished in both patients...

..In the setting of right cerebral or right arm embolization, when no source is seen in the arch on TEE, gadolinium-enhanced MRA should be considered...

..We investigated the role of three-dimensional echocardiography in assessing mitral valve anatomy in greater detail in patients immediately before and after balloon mitral valvuloplasty (BMV)...

..Its presence may also alert the echocardiographer to the possibility of an ASD when the septal defect cannot be visualized directly...

..3) The high prevalence of abdominal aneurysm in patients with thoracic atheromas suggests that screening for abdominal aneurysm should be carried out in all patients with thoracic atheromas identified by TEE...

..These unusual views of the pulmonic valve leaflets were obtained because of anterior displacement of the pulmonary artery, and precise anatomic delineation of the problem in each case was possible with transthoracic echocardiography...

..Options include off-pump CABG or coronary angiography via a brachial (rather than femoral) approach...

..Although benign, these tumors may develop in all four cardiac chambers and result in pulmonary or systemic embolization. Paraplegia is a rare embolic complication...

..The study compared a hand-carried echocardiography (HC) device with standard echocardiography (SE) in critically ill patients...

..However, the complications associated with traditional aortic valve replacement still occur. Echocardiography is valuable both for intraoperative monitoring and follow-up of this new procedure...

..Transesophageal echocardiography provided crucial information about the intimal flap puncture site and true- and false-lumen blood flow. After the flap fenestration, false-lumen blood flow increased, and the patient improved clinically...

..Great care must be taken if passage of the probe through the esophagus is met with resistance, to avoid serious complications...

..CONCLUSION: For the first time at NYUMC, a multidisciplinary team was given the mandate to achieve major changes in an entire patient care process. Similar projects are now underway...

..008). Severe thoracic aortic plaque is strongly associated with RAS, which is found in 19% of patients with severe plaque. Patients found to have severe aortic plaque on transesophageal echocardiography should be screened for RAS...

..Although using a smaller probe is attractive, the quality of images it generates when used in adults has not yet been examined...

..Because of the close anatomic relation between the abdominal aorta and the inferior vena cava, we hypothesized that these probes would be useful in the evaluation of the abdominal aorta and the renal arteries...

..This technique may prove to be of significant clinical value, enabling rapid and accurate assessment of global and segmental myocardial function...

..Pulsus alternans is usually a systolic phenomenon. We present a case of a patient with severe heart failure, and systolic and diastolic pulsus alternans. This case may help clarify the mechanism of pulsus alternans...

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..Pressures and flows can be estimated or measured with enough accuracy to allow for clinical decision-making. We present a case with an unusual Doppler echocardiographic finding and discuss its derivation...

..This method should have clinical applicability because it is not flow dependent and can be used in patients with normal, reduced, or increased stroke volume...

..The PISA calculation correlated well with shunt estimation by echocardiographic volumetric methods and by oximetry...

..There was also a trend toward elevated fibrinogen, homocysteine, and apo (a) concentrations as well as lower antithrombin III concentrations in these patients...

..CONCLUSIONS: Aortic valve thickening without stenosis is common, and it may progress to significant AS. It is possible that this development of AS may be responsible for some of the increased morbidity and mortality in patients with AVT...

..Recent literature on the use of percutaneous closure devices for patent foramen ovale is reviewed...

..It is also important to ensure that the needle stick is just lateral to the artery, to avoid hitting the left lung...

..This case illustrates the importance of using combined imaging modalities for the diagnosis and management of cardiac masses...

..This may cause dyspnea due to elevated pulmonary venous pressures. This report describes an unusual pulmonary vein blood flow pattern in a patient with lung metastases...

..Thus, thrombus formation occurred despite a 'successful' epicardial exclusion of the distal LAA...

..Furthermore, Doppler study showed not only a large left-to-right shunt but also a diastolic right-to-left shunt, which explained the patient's hypoxia...

..2% and severe TR developed in 3.9% of patients with initially normal TR. TR worsened by at least 1 grade in 24.2%. Patients with ICDs had a higher rate of TR worsening compared with patients with PPMs (32.4% vs. 20.1%; P < .05)...

..The TEE findings correlated well with the results of chest CT. Using TEE for the identification of the aortic branches in patients with chest trauma may be critical...

..The cause of PSM is unknown; prevailing theories include: (1) operation on the heart alters the degree to which it is restrained by the pericardium and the chest wall and (2) transient ischemia alters septal motion...

..The two discs of the tricuspid prosthesis were immobilized, half open and half closed. The prosthesis was replaced and the patient did well...

..02). CONCLUSION: Patients without preserved valve function (those with moderate or severe regurgitation) have a significantly worse outcome (57% mortality) than do those with normal valvular function (10% mortality)...

..CONCLUSION: Despite advances in imaging during 12 years, TTE is still insensitive compared with TEE for the detection of native valve vegetations, and fails to demonstrate nearly half of them...

..Doppler echocardiography demonstrated a rare flow pattern due to cor triatriatum that is also present in subvalvular or supravalvular mitral stenosis: a forward gradient, in both systole and diastole...

..This review explores the current literature on the use of HCU in the critical care setting, discusses the limitations of HCU, and examines the costs of implementing this new technology...

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..The use of a combined probe may be the technique of choice for patients who require both cardioversion and transesophageal echocardiography...