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Kallel O, Charmake D, Chergui I, El Ouafi N, Ismaili N. Patent foramen oval: A rare case of acute ischemia of the upper limb: A case with 2 year follow-up. Ann Med Surg (Lond) 2021; 63:102188. [PMID: 33717477 PMCID: PMC7921751 DOI: 10.1016/j.amsu.2021.102188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction and importance Paradoxical emboli (PDE) represent less than 2% of all arterial emboli, that is why they are considered as a rare event. We notice that the upper limb ischemia is very exceptional as part of a paradoxical embolism. This case presentation can help in considering the diagnosis the PFO as one of the most important risk factors of paradoxical embolism. Case presentation Here, we present a rare case of a 69-year-old woman with paradoxical systemic arterial embolism, presented by an acute ischemia of the upper limb, secondary to deep venous thrombosis and pulmonary embolism in the presence of patent foramen ovale, treated with long-term anticoagulation with rivaroxiban 20 mg/day, because of the mutation of the Factor II whish indicate already the anticoagulation. Discussion Echocardiographic techniques such as transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), or transcranial echocardiography (TCE) are the principal tools used to detect PFO. There are no clear consensus on the treatment of PDE. Presenting symptoms largely depend upon the location of the embolus, necessitating a different approach for each patient, but There is essentially three therapeutic options: surgical embolectomy, thrombolysis, and anticoagulation. Conclusion PFO closure is, today, a standardized and safe intervention, but the indication stay individualized to each patient. Paradoxical emboli represent less than 2% of all arterial emboli, that is why they are considered as a rare event. The patent foramen oval stay the most frequent intracardiac defect associated with paradoxical emboli. transesophageal echocardiography TEE is the most reliable diagnostic test of the patent foramen oval. Recommendations for treatment should be individualized.
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Affiliation(s)
- O Kallel
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco
| | - D Charmake
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco
| | - I Chergui
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco
| | - N El Ouafi
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco.,Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed the First University of Oujda, Morocco
| | - N Ismaili
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco.,Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed the First University of Oujda, Morocco
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Impending paradoxical embolism, patent foramen ovale and pregnancy. Case report. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2018. [DOI: 10.1097/cj9.0000000000000015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Vaiano AS, Valente C, De Benedetti G, Caramello G. Transient cortical blindness after intradiscal oxygen-ozone therapy. Indian J Ophthalmol 2017; 64:944-946. [PMID: 28112142 PMCID: PMC5322716 DOI: 10.4103/0301-4738.198858] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A 54-year-old caucasian male developed bilateral blindness during an oxygen–ozone injection for disc herniation. The visual loss (VL) was immediately followed by severe frontal headache, vomiting, and nausea. The patient underestimated the VL showing Anton's syndrome, with a complete visual recovery after 2-month follow-up. Magnetic resonance data were consistent with recent ischemic lesions in bilateral vascular territories of posterior cerebral arteries.
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Affiliation(s)
| | - Cristiana Valente
- Struttura Complessa di Oculistica, Azienda Ospedaliera Santa Croce e Carle di Cuneo, Cuneo, Italy
| | | | - Guido Caramello
- Struttura Complessa di Oculistica, Azienda Ospedaliera Santa Croce e Carle di Cuneo, Cuneo, Italy
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Benito-González T, Díez-Fernández F, Pérez de Prado A. Respiratory Failure Associated with Diaphragmatic Paralysis: Just a Ventilation/Perfusion Problem? Arch Bronconeumol 2016; 52:566-567. [PMID: 27107666 DOI: 10.1016/j.arbres.2016.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/13/2016] [Accepted: 03/14/2016] [Indexed: 11/18/2022]
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Erkoç MF, Öztoprak B, Okur A, Ede H, Örsçelik Ö, Kantarcı M, Kızrak Y. The relationship of patent foramen ovale location with severity of stroke: A new risk factor for paradoxical embolism. Acta Clin Belg 2016; 71:149-53. [PMID: 27075798 DOI: 10.1080/17843286.2016.1138619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Patent foramen ovale (PFO) is a common developmental anomaly and is well associated with paradoxical embolism and cryptogenic stroke. The aim of this study was to investigate the relationship of PFO location with severity of cryptogenic stroke. MATERIALS AND METHODS Fifty patients with cryptogenic stroke and echocardiographically proven PFO were classified according to the severity of stroke. In order to define the location of PFOs, an imaginary line dividing the length of interatrial septum vertically into two equal parts was drawn manually at axial plane on cardiac multidetector computed tomography. PFOs located at superior part of this imaginary line was defined as superiorly located PFO, while PFOs located at inferior part of this imaginary line was defined as inferiorly located PFO. RESULTS Fourteen patients (28%) revealed mild, 20 patients (40%) revealed moderate and 16 patients (32%) had severe stroke. Based on PFO location, there were 34 patients (68%) with superiorly (group 1), and 16 patients (32%) with inferiorly (group 2) located PFO. It was found that patients of group 1 had significantly higher frequency of moderate or severe stroke compared to those of group 2 (p < 0.005) CONCLUSION: In conclusion, the patients with superiorly located PFO had higher frequency of severe stroke compared to the patients with inferiorly located PFO. Since this is a preliminary study, clinical application and importance of this finding necessitates further large-scale interventional studies.
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Laguna G, Arce N, Blanco M, Carrascal Y. Red de Chiari y embolia paradójica. Respuesta. Rev Esp Cardiol (Engl Ed) 2015. [DOI: 10.1016/j.recesp.2014.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Laguna G, Arce N, Blanco M, Carrascal Y. Chiari network and paradoxical embolism. Response. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2015; 68:274. [PMID: 25649974 DOI: 10.1016/j.rec.2014.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Gregorio Laguna
- Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
| | - Nuria Arce
- Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Miriam Blanco
- Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Yolanda Carrascal
- Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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[Acute myocardial infarction due to a coronary embolism and a massive pulmonary thromboembolism in a young patient. A difficult to manage combination]. Semergen 2014; 41:e67-9. [PMID: 25440974 DOI: 10.1016/j.semerg.2014.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 07/28/2014] [Accepted: 08/02/2014] [Indexed: 11/20/2022]
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Hernández-Enríquez M, Freixa X. Indicaciones actuales de cierre percutáneo del foramen oval permeable. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2014.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Merino Argumánez C, Mérida García A, Sierra Bracamonte M, Maestro de la Calle G, Mateo Álvarez S. Síndrome de platipnea-ortodeoxia. Rev Clin Esp 2014; 214:e65-7. [DOI: 10.1016/j.rce.2014.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 01/29/2014] [Accepted: 02/02/2014] [Indexed: 10/25/2022]
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Hernández-Enríquez M, Freixa X. Current indications for percutaneous closure of patent foramen ovale. ACTA ACUST UNITED AC 2014; 67:603-7. [PMID: 25037538 DOI: 10.1016/j.rec.2014.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 01/11/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Marco Hernández-Enríquez
- Sección de Cardiología Intervencionista, Instituto del Tórax, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain
| | - Xavier Freixa
- Sección de Cardiología Intervencionista, Instituto del Tórax, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain.
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Casanovas-Marbà N, Feijoo-Massó C, Guillamón-Torán L, Guillaumet-Gasa E, Blanco BGD, Martínez-Rubio A. Patent foramen ovale causing severe hypoxemia due to right-to-left shunting in patients without pulmonary hypertension. Clinical suspicion clues for diagnosis and treatment. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2014; 67:324-325. [PMID: 24774598 DOI: 10.1016/j.rec.2013.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 09/18/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Núria Casanovas-Marbà
- Servicio de Cardiología, Hospital de Sabadell-Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain
| | - Carlos Feijoo-Massó
- Servicio de Cardiología, Hospital de Sabadell-Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain
| | - Laura Guillamón-Torán
- Servicio de Cardiología, Hospital de Sabadell-Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain
| | - Eva Guillaumet-Gasa
- Servicio de Cardiología, Hospital de Sabadell-Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain
| | | | - Antoni Martínez-Rubio
- Servicio de Cardiología, Hospital de Sabadell-Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain.
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Casanovas-Marbà N, Feijoo-Massó C, Guillamón-Torán L, Guillaumet-Gasa E, García-del Blanco B, Martínez-Rubio A. Hipoxemia grave por shunt derecha–izquierda a través del foramen oval en ausencia de hipertensión pulmonar. Existe y se puede tratar con éxito. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.09.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Li Y, Ya-nan Z, Li-qun W. Which Technique Is Better for Detection of Right-to-Left Shunt in Patients with Patent Foramen Ovale: Comparing Contrast Transthoracic Echocardiography with Contrast Transesophageal Echocardiography. Echocardiography 2014; 31:1050-5. [PMID: 24495142 DOI: 10.1111/echo.12523] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yue Li
- Ultrasound Department of Chinese; PLA General Hospital; Beijing China
| | - Zhai Ya-nan
- Ultrasound Department of Chinese; PLA General Hospital; Beijing China
| | - Wei Li-qun
- Ultrasound Department of Chinese; PLA General Hospital; Beijing China
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Intervencionismo en cardiopatía estructural. Más allá de la terapia valvular transcatéter. Rev Esp Cardiol 2012; 65:405-13. [DOI: 10.1016/j.recesp.2011.12.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 12/14/2011] [Indexed: 11/20/2022]
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Siniorakis E, Arvanitakis S, Skandalakis N, Barlagiannis D. [Elderly patient with platypnea-orthodeoxia: check the ascending aorta]. Rev Esp Cardiol 2011; 64:1074-5. [PMID: 21616578 DOI: 10.1016/j.recesp.2011.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 01/31/2011] [Indexed: 11/16/2022]
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Ramos-Leví AM, Díaz-Pérez JA, Poves C, Bover R. [Carcinoid tumor and patent foramen ovale]. ENDOCRINOLOGIA Y NUTRICION : ORGANO DE LA SOCIEDAD ESPANOLA DE ENDOCRINOLOGIA Y NUTRICION 2011; 58:206-209. [PMID: 21397575 DOI: 10.1016/j.endonu.2011.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 01/16/2011] [Accepted: 01/18/2011] [Indexed: 05/30/2023]
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Cruz-González I, Diaz TA, Inglessis-Azuaje I, Palacios IF. Use of a second device for the closure of patent foramen ovale. Rev Esp Cardiol 2010; 63:1384-6. [PMID: 21070737 DOI: 10.1016/s1885-5857(10)70266-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cruz-González I, Diaz TA, Inglessis-Azuaje I, Palacios IF. Segundo dispositivo para el cierre de un foramen oval permeable. Rev Esp Cardiol (Engl Ed) 2010. [DOI: 10.1016/s0300-8932(10)70311-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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[Retrospective case analysis of ophthalmological and systemic risk factors in patients with retinal vascular occlusion]. Ophthalmologe 2010; 107:446-51. [PMID: 19756639 DOI: 10.1007/s00347-009-2018-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim was to determine systemic risk factors for acute central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) and to evaluate the usefulness of systemic diagnostics in CRAO and CRVO. METHODS The study consisted of a retrospective chart review including 80 patients (CRAO 38, CRVO 42). All patients underwent systemic diagnostics including blood pressure measurement, blood cholesterol level, carotid Doppler imaging, transthoracic echocardiography (TTE), intraocular pressure measurement, glaucoma history and presence of thrombophilic factors. A systemic medical history was obtained. RESULTS Systemic hypertension was found in 76.3% CRAO and 75.6% CRVO patients. Abnormal cardiac findings were detected in 61% (CRAO) and 22% (CRVO). Abnormal carotid findings were detected in 44.1% for CRAO and 9.5% for CRVO. Pathological thrombophilic factors were found in both groups for approximately 15%. CONCLUSIONS TTE and carotid Doppler are important tools in the diagnosis of sources of emboli in patients with CRAO, while for CRVO abnormal findings are revealed by TTE and carotid Doppler less often. Thrombophilia should be ruled out in the absence of common risk factors, especially in younger patients and systemic hypertension should be adequately controlled.
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Mills P, Timmis A, Huber K, Ector H, Lancellotti P, Masic I, Ivanusa M, Antoniades L, Aschermann M, Videvaek J, Laucevicius A, Mustonen P, Artigou JY, Vardas P, Stefanadis C, Chiariello M, Bolognese L, Ambrosio G, van der Wall EE, Kulakowski P, Pinto FJ, Apetrei E, Oganov RG, Kamensky G, Lüscher TF, Lerch R, Haouala H, Sansoy V, Shumakov V, Tajer CD, Lau CP, Márquez M, Krittayaphong R, Arai K, Alfonso F. The role of European national journals in education. Rev Esp Cardiol 2009; 62:1494-1497. [PMID: 20038420 DOI: 10.1016/s1885-5857(09)73548-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Mills P, Timmis A, Huber K, Ector H, Lancellotti P, Masic I, Ivanusa M, Antoniades L, Aschermann M, Videvæk J, Laucevicius A, Mustonen P, Artigou JY, Vardas P, Stefanadis C, Chiariello M, Bolognese L, Ambrosio G, van der Wall EE, Kulakowski P, Pinto FJ, Apetrei E, Oganov RG, Kamensky G, Lüscher TF, Lerch R, Haouala H, Sansoy V, Shumakov V, Tajer CD, Lau CP, Márquez M, Krittayaphong R, Arai K, Alfonso F. El papel de las revistas nacionales europeas en la formación médica. Rev Esp Cardiol 2009. [DOI: 10.1016/s0300-8932(09)73139-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Desaturación brusca intraoperatoria: otra manifestación del foramen oval permeable. Rev Esp Cardiol (Engl Ed) 2009. [DOI: 10.1016/s0300-8932(09)72107-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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González IA, Revilla A, Fernández B, San Román JA. Sudden intraoperative oxygen desaturation: another sign of patent foramen ovale. Rev Esp Cardiol 2009; 62:1068-9. [PMID: 19712630 DOI: 10.1016/s1885-5857(09)73275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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[Update on cardiac imaging techniques: echocardiography, cardiac magnetic resonance, and multidetector computed tomography]. Rev Esp Cardiol 2009; 62 Suppl 1:129-50. [PMID: 19174056 DOI: 10.1016/s0300-8932(09)70047-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This article contains a review of the most important publications on cardiac imaging that have appeared during 2008. During the year, we assisted with the clinical implementation of three-dimensional real-time transesophageal echocardiography, with the use of echocardiography for selecting patients for and monitoring those who underwent percutaneous aortic valve replacement (the majority of centers performing the technique were still in the learning phase), and with the emergence in the clinic of techniques for studying myocardial deformation. Also reviewed are the most significant developments in the application of echocardiography to coronary heart disease and cardiac resynchronization therapy and in 2 other techniques whose use is constantly increasing: cardiac magnetic resonance and multidetector cardiac computed tomography. The review ends with a description of the current state of the art in contrast echocardiography, with particular emphasis on safety in the context of recommendations made by the US Food and Drug Administration at the end of 2007.
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