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You JY, Chun EJ, Choi SI, Joe E, Lee W, Kang JW, Seo MK, Yoon YE, Oh IY, Kim E, Lim TH. Clinical significance of incidentally detected aneurysms of the membranous ventricular septum in adults by multidetector computed tomography. Am J Cardiol 2015; 115:354-9. [PMID: 25491239 DOI: 10.1016/j.amjcard.2014.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 11/01/2014] [Accepted: 11/01/2014] [Indexed: 11/15/2022]
Abstract
Although the clinical relevance of aneurysm of the membranous ventricular septum (AMVS) in adults is unclear, the frequency of AMVS detection has been increased because cardiac multidetector computed tomography has been widely adopted for the evaluation of coronary artery disease. Therefore, we aimed to assess the clinical significance of AMVS in a longitudinal study. In 30,120 adults with suspected coronary artery disease who underwent cardiac multidetector computed tomography in 3 hospitals, 52 patients with AMVS were retrospectively selected. We evaluated the clinical symptoms and electrocardiographic abnormalities (cross-sectional study) and the prevalence of embolic stroke (observational study) during a median 40-month (range 6 to 74 months) observation period. For the assessment of embolic stroke, we excluded 9 patients with other explainable embolic sources. Conduction abnormalities were noted in 13 of 52 adults (25%) with AMVS on electrocardiography and embolic stroke occurred in 6 of 43 patients (14%). The mean age and the prevalence of hypertension were significantly higher in the embolic stroke group than in the event-free group (p <0.05). Thrombi were detected in the 11.6% of AMVS, which was significantly related with embolic stroke (p <0.05). The size and morphology did not change in 15 patients with serial follow-up images. In conclusion, our study suggests that AMVS in adults should not be ignored because AMVS may be related to conduction abnormality or embolic stroke, and it does not spontaneously resolve or diminish in size.
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Affiliation(s)
- Ja Yeon You
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea
| | - Eun Ju Chun
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea.
| | - Sang Il Choi
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea
| | - Eugene Joe
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea
| | - Whal Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Joon-Won Kang
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Myung-Ki Seo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yeonyee E Yoon
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea
| | - Il-Young Oh
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea
| | - Eunhee Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea
| | - Tae-Hwan Lim
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Kamra K, Russell I, Miller-Hance WC. Role of transesophageal echocardiography in the management of pediatric patients with congenital heart disease. Paediatr Anaesth 2011; 21:479-93. [PMID: 21481076 DOI: 10.1111/j.1460-9592.2011.03570.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Transesophageal echocardiography (TEE) has become a critical diagnostic and perioperative management tool for patients with congenital heart disease (CHD) undergoing cardiac and noncardiac surgical procedures. This review highlights the role of TEE in routine management of pediatric cardiac patient population with focus on indications, views, applications and technological advances.
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Affiliation(s)
- Komal Kamra
- Department of Anesthesiology, Stanford University, Lucile Packard Children’s Hospital, Palo Alto, CA, USA.
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Piatkowski R, Budaj-Fidecka A, Scislo P, Kochanowski J, Śpiewak M, Opolski G. Transesophageal Real Time Three-Dimensional Echocardiography in Assessment of Partial Atrioventricular Septal Defect. Echocardiography 2009; 26:1092-4. [DOI: 10.1111/j.1540-8175.2009.00948.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Weir RAP, Steedman T, Hillis WS, Swan L. Relief of Fontan obstruction demonstrated non-invasively by cardiac magnetic resonance imaging. Int J Cardiol 2008; 127:e167-9. [PMID: 17643511 DOI: 10.1016/j.ijcard.2007.04.124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2007] [Accepted: 04/25/2007] [Indexed: 11/26/2022]
Abstract
Greater numbers of children with congenital heart disease are surviving to adulthood. The non-invasive assessment and surveillance of these patients, still based primarily on transthoracic echocardiography, has been significantly enhanced by the advent, and more widespread use of, cardiac magnetic resonance imaging. We report on the influence of cardiac magnetic resonance imaging in the initial evaluation of, and response to treatment in, a patient who had developed an obstruction within her Fontan circuit.
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