- SINGLE ventricle (SV) defects are congenital cardiac anomalies in which 1 of the 2 ventricles is severely hypoplastic or absent. The atrioventricular valve and arterial outflow valve associated with the hypoplastic ventricle are also absent or hypoplastic. Usually a biventricular repair is impossible, and these patients often require a series of palliative procedures. There are many anatomic subtypes and variations of SV defects, and the nomenclature can be confusing.1 SV defects are classified as right or left ventricle morphology depending on the functioning well-developed ventricle.
- CONGENITAL sinus of Valsalva (SoV) aneurysm is a rare finding and a dilation of a single SoV caused by a separation between the aortic media and annulus fibrosis. This most commonly originates from the right coronary sinus (65%-85%), less commonly from the noncoronary sinus (10%-30%), and rarely from the left coronary sinus (<5%).1 Associated congenital conditions include ventricular septal defects (30%-60%), aortic insufficiency (20%-30%), and bicuspid aortic valve (AV) (10%) and less common pulmonary stenosis, coarctation, and atrial septal defects.
- Obstructive lesions to the pulmonary circulation present with nonspecific symptoms varying from chest pain, dyspnea on exertion, and cough to florid right heart failure.1 Congenital pulmonic stenosis, pulmonary embolism (PE), and chronic thromboembolic pulmonary hypertension (CTEPH) are common etiologies.2 Primary tumors of the pulmonary vasculature are less common and more likely occur owing to metastatic involvement.3 Given the rarity of these tumors, their presentation commonly is misdiagnosed, and patients commonly are treated for chronic thromboembolism.
- PATIENT-PROSTHESIS mismatch (PPM) is said to be present when the indexed effective orifice area (iEOA) of the implanted prosthetic valve is less than 0.85 cm2/m2. It is associated with increased operative mortality, decreased regression of the left ventricular (LV) mass, and reduced long-term survival.1,2 In the presence of a small aortic annulus, severe PPM may occur unless the aortic root is enlarged during surgery. The postoperative complications associated with the aortic root enlargement (ARE) may be detected on intraoperative transesophageal echocardiography (TEE).
- AORTIC INSUFFICIENCY (AI) in patients after left ventricular assist device (LVAD) implantation is one of the unintended and potentially harmful consequences.1,2 Excessive LVAD flows, resulting in diminished and infrequent aortic valve (AV) opening, may facilitate AI progression and extend its duration to the systolic phase of the cardiac cycle.2,3 The high temporal resolution of the echocardiographic M mode makes it very effective in monitoring the effects of LVAD speeds on AV function in real time.
- IN ADDITION TO 2-dimensional (2D) echocardiography, 3-dimensional (3D) transesophageal echocardiography (TEE) is becoming a valuable complementary tool in providing accurate diagnosis, guiding different percutaneous procedures, and accurately managing and diagnosing possible complications. This report describes the case of a patient with symptoms of rheumatic mitral stenosis (MS) who developed acute severe mitral regurgitation (MR) after percutaneous mitral balloon valvotomy (PMBV).
- IN CERTAIN congenital heart diseases, such as corrected transposition of the great arteries or the double-outlet right ventricle (RV) with a hypoplastic left ventricle (LV), the RV assumes the role of a systemic ventricle after cardiac surgery. As the patient grows older, progressive valvular dysfunction can develop, and the valve of the RV needs to be replaced.
- INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) is useful in estimating flow velocities and pressure gradients across prosthetic valves. A double-envelope velocity-time integral (VTI) curve typically is observed on continuous-wave Doppler (CWD) interrogation of aortic valve prosthesis,1 which is attributed to a difference in the flow velocities across the left ventricular outflow tract and the prosthesis.
- WITH 1-YEAR survival figures on the order of 70% to 80%,1,2 lung transplantation is an established and viable treatment option for a variety of end-stage lung diseases. Although primary graft failure and infection remain the greatest causes of early mortality in this group of patients,2,3 pulmonary venous anastomotic thrombosis (PVT) is well recognized as a potentially fatal early complication of lung transplantation.3-5