35例窦缓者食道调搏电生理测定报告

本文报告35例不明原因窦缓者的食道调搏电生理检查结果,着重对反映窦房结功能的心脏固有心率。窦房结恢复时间、校正窦房结恢复时间、窦房传导时间进行分析,并揭示了其相关性。     

Evaluation of left ventricular performance during sympathetic nervous storm in a case with severe tetanus by transesophageal M-mode echocardiography

Transesophageal M-mode echocardiography was applied for the evaluation of left ventricular performance in a case of severe tetanus with labile hypertension due to sympathetic nervous ‘torm’. When systemic blood pressure was elevated, increases in pulmonary arterial pressure, cardiac output, left ventricular enddiastolic diameter, fractional shortening and mean velocity of circumferential fiber shortening were noted. No changes were found in total peripheral vascular resistance or left ventricular endsystolic diameter. Positive pressure ventilation, rendered standard transthoracic echocardiography ineffective.     

自制便携式心律失常治疗仪在院前急救中的运用

目的探讨自制便携式心律失常治疗仪在院前急救中治疗阵发性室上性心动过速的疗效和安全性。方法在院前急救中应用自制便携式心律失常治疗仪经食道心房调搏方法治疗阵发性室上性心动过速,并与药物(普罗帕酮)组对照,观察两组成功率和不良反应。结果50例患者,调搏组28例,成功率为89.29%;药物组22例,成功率77.27%(P>0.05)。调搏组终止时间为(10.84±6.14)min,药物组为(36.65±14.50)min(P<0.001);调搏组不良反应(1.29±0.46)项次,药物组2.41±0.80项次(P<0.001)。结论自制便携式心律失常治疗仪在院前急救中治疗阵发性室上性心动过速疗效肯定,且简单易行、安全有效,值得推广。     

Manutenção da anestesia inalatória com a máscara facial Janus para substituição de válvula aórtica transcateter: uma série de casos

Background and objectives

Aortic stenosis is the most common type of heart valve disease. Percutaneous aortic valve replacement has become the alternative for patients considered at high risk for surgery. Controlled mechanical ventilation with tracheal intubation has been the choice for this type of procedure, however the use of noninvasive ventilation in cardiac patients has shown to be beneficial. Janus is a novel full‐face mask that allows application of noninvasive ventilation support during anesthesia. Our main objective was to evaluate the feasibility of transcatheter aortic valve replacement with prolonged transesophageal echocardiographic monitoring under deep inhalational sedation delivered through a new mask for noninvasive ventilation.

经胃底心室短轴切面超声评价左心室功能100例分析

以经食道心脏超声技术,从胃底心室短轴切面对100例患者评价了其左心室功能。结果显示,经胃底超声计算的左心室容积、射血分数与同期左心室造影值接近(P>0.05),而左心室射血分数或心室周径缩短分数与患者临床心功能状态亦相关良好(r=-0.89,-0.81,P<0.01,n=100)。结论为,经胃底心室短轴切面超声评价左心室功能精确,可信。无创伤、可连续重复监测为其优点。     

Tornado-like appearance of spontaneous echo contrast assessed by real-time 3D transesophageal echocardiography

We report a case showing that real-time 3D transesophageal echocardiography provides unique information about the dynamic nature of spontaneous echo contrast (SEC) in 3D space and has the potential to provide better understanding of SEC. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Usefulness of transesophageal echocardiography for identifying the precise location of a left ventricular rupture in a patient with collapsed cardiac chamber

We report an emergent case of cardiac tamponade due to rupture of the left ventricle. Preload and intracardiac volume were decreased by percutaneous cardiopulmonary support (PCPS), which led to the collapse of the cardiac chamber. The collapsed cardiac chamber made it difficult to diagnose cardiac abnormalities by preoperative transthoracic echocardiography (TTE). On loading fluid infusion and transfusion as volume load to improve the hemodynamic status, transesophageal echocardiography (TEE) revealed several leakages in the left ventricular myocardium. Continuous careful observation on TEE led us to a confident diagnosis of left ventricular rupture. The diagnosis by TEE also led to the employment of the appropriate procedure. TEE is useful for detecting an abnormality due to the location of the cardiac chamber and echocardiographic probe. We also note that continuous careful observation led to the employment of the appropriate procedure.     

A novel view for visualizing a left pulmonary artery thromboembolus with intraoperative transesophageal echocardiography

Visualization of thromboembolic material in the pulmonary artery is often difficult on transesophageal echocardiography, especially in the left pulmonary artery, because of the position of the left main bronchus. We present a case in which thromboembolic material within the midleft pulmonary artery was incidentally diagnosed using additional, modified transesophageal echocardiography views, in a patient undergoing mitral valve repair.