Coronary Sinus Visualization by 3-dimensional Real-time Echocardiography

BACKGROUND

Real-time 3-dimensional echocardiography (RT3DE) to visualize the coronary sinus (CS) was compared with multislice cardiac tomography (MSCT).

METHODS

In all, 37 consecutive patients undergoing MSCT received RT3DE a few hours later. Group A (n = 22) had normal left ventricular dimension/function, whereas group B (n = 15) had heart failure.

RESULTS

The CS could be visualized in both groups (91% and 93%) with a significantly larger diameter in B. Systolic CS diameter was always larger than diastolic, but patients with heart failure showed significantly less difference (7.6% +/- 4.2% vs 12.2% +/- 6.1%, P < .05). When systolic and diastolic measurements were possible, MSCT and RT3DE agreed (Lin R = -0.09 [95% confidence interval 0.73-0.93]) but less so from the proximal to mid/distal segments (Lin R 0.90, 0.61, 0.41, respectively). Observers learned the procedure in approximately 5 minutes.

CONCLUSION

The CS can be visualized and quantitatively assessed by RT3DE in an easily learned procedure that agrees with MSCT results, especially in patients with heart failure.

Recurrent atrial myxoma

We have chosen this case of sporadic atrial myxoma for our presentation because it had a particular evolution, with recurrence at 8 years after surgical excision (echocardiography was performed every year) and a particular diagnostic means - at echocardiographic follow-up, the patient being asymptomatic. This presentation, together with a review of literature included in the article, emphasizes the importance of a careful postoperative follow-up of the patients and the existence of some particular aspects of the evolution and symptomatology of recurrent atrial myxoma.

Anterolateral papillary muscle rupture: diagnosis and successful treatment (a case report)

We report the case of a young man presenting with chest pain, dyspnea, and syncope in whom transthoracic and transesophageal echocardiography helped to diagnose anterolateral papillary muscle rupture. After cardiac catheterization (which confirmed the severe mitral regurgitation and showed two vessel coronary disease), mitral valve replacement was performed together with coronary bypass grafting.