Prenatal diagnosis of congenital absence of aortic valve associated with restrictive foramen ovale: Hemodynamic features and clinical outcome

We present the case of a fetus with absent aortic valve (AAV), mitral regurgitation (MR), and restrictive foramen ovale (FO) who survived in utero but died of severe hypoxia after birth. We reported previously two cases of “inverse circulatory shunt” in AAV with MR, that is, blood from the ascending aorta flowing into the left ventricle through aortic regurgitation, to the left atrium due to MR, to the right atrium through FO, to the right ventricle, then to the pulmonary arteries, and to the ascending aorta through the ductus. In the present case, restrictive FO prevented inverse circulatory shunt, but resulted in postnatal death.     

A case of unicuspid aortic valve associated with a single coronary artery and ventricular septal defect

The patient was a 26-year-old man who had undergone patch closure of a ventricular septal defect at 2 years of age. After this surgery, his condition was satisfactory until he visited our hospital for treatment of paroxysmal supraventricular tachycardia in November 2000. Echocardiography revealed moderate to severe aortic valve regurgitation and dilatation of the left ventricle and ascending aorta. These echocardiographic abnormalities were attributed to a bicuspid aortic valve. Coronary angiography suggested the presence of a single coronary artery originating from the left Valsalva sinus. We performed Bentall’s operation in January 2003. The intraoperative findings revealed that the aortic valve consisted of an extensively calcified single cusp, and there was a single coronary artery originating from the left Valsalva sinus. Because adult patients with a unicuspid aortic valve are rare, and no cases of unicuspid aortic valve associated with a single coronary artery have been reported, we herein report this case with a review of the literature.This paper was presented at the 19th meeting of the Chubu Chapter of the Japan Society of Ultrasonics in Medicine.     

The coexistence of left ventricular non-compaction cardiomyopathy,significant coronary artery disease and massive thrombus formation in left ventricular cavity: A rare case report

Non-compaction of the left-ventricular myocardium is an extremely rare cardiomyopathy. The most common clinical manifestations are heart failure, ventricular arrhythmia, thromboembolism, and sudden cardiac death. The condition is diagnosed by two-dimensional echocardiography or magnetic resonance imaging. We report a rare case of a 55-year-old man with coexistence of left ventricular non compaction cardiomyopathy, significant coronary artery disease and massive thrombus formation within recesses in left ventricular cavity.     

超声速度向量成像技术评价主动脉瓣置换同期冠状动脉旁路移植术患者左心室长轴收缩功能

目的 探讨超声速度向量成像(VVI)技术评价主动脉瓣置换同期施行冠状动脉旁路移植术(CABG)患者手术前、后左心室长轴收缩功能的价值。 方法 应用Siemens Sequoia 512超声诊断仪及VVI技术,于术前、术后2周及术后3个月对23例主动脉瓣置换同期接受CABG患者(手术组)行超声心动图检查,并对其左心室16节段心肌长轴方向的收缩期平均峰值速度、应变、应变率进行定量分析;选取20名健康查体者作为对照组。 结果 手术组左心室长轴各节段收缩期平均峰值速度、应变和应变率术前组明显低于对照组(P均<0.01),术后2周左心室长轴基底段及中间段收缩期平均速度、应变和应变率较术前减低(P均<0.01),术后3个月各节段平均收缩期速度、应变和应变率较术前明显好转(P均<0.01)。左心室射血分数、短轴缩短率组间差异无统计学意义。 结论 VVI技术能较常规超声技术更加客观、敏感地评价主动脉瓣置换同期CABG术后患者心功能的变化。     

Determination of the threshold of cardiac troponin I associated with an adverse postoperative outcome after cardiac surgery: a comparative study between coronary artery bypass graft,valve surgery,and combined cardiac surgery

Introduction  

The objective of the present study was to compare postoperative cardiac troponin I (cTnI) release and the thresholds of cTnI that predict adverse outcome after elective coronary artery bypass graft (CABG), after valve surgery, and after combined cardiac surgery.