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A Case of Coarctation of Aorta with Left Isomerism Associated with Inferior Vena Cava Interruption and Polysplenia.

Gwan Hyeop SOHN ; Kyoung Min BYUN ; Hye Jin HAN ; Hak Jin KIM ; Jin Oh CHOI ; Sang Chol LEE ; Seung Woo PARK

Journal of Cardiovascular Ultrasound.2007;15(1):27-29.

A 27-year-old female visited outpatient clinic for the evaluation of palpitation and dyspnea on exertion. Echocardiographic examination including transthoracic and transesophageal echocardiography revealed coarctation of aorta, bicuspid aortic valve, mitral valve prolapse, and sealed-up ventricular septal defect. Further evaluation with computed tomography angiography revealed another combined congenital anomaly of left isomerism with polysplenism and interrupted inferior vena cava and pulmonary embolism with deep vein thrombosis. After corrective surgery for the coarctation, she received anticoagulation therapy for the treatment and the secondary prevention of pulmonary embolism.
Adult ; Ambulatory Care Facilities ; Angiography ; Aortic Coarctation* ; Aortic Valve ; Bicuspid ; Dyspnea ; Echocardiography ; Echocardiography, Transesophageal ; Female ; Heart Septal Defects, Ventricular ; Humans ; Isomerism* ; Mitral Valve Prolapse ; Pulmonary Embolism ; Secondary Prevention ; Vena Cava, Inferior* ; Venous Thrombosis

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Giant Coronary Sinus Caused by Absent Right and Persistent Left Superior Vena Cava and Severe Tricuspid Regurgitation.

Jeung Hoan PAIK ; Tae Ho PARK ; Young Hoon KIM ; Hee Kyung BAEK ; Jin HAN ; Kyung Ho KIM ; Kwang Soo CHA ; Moo Hyun KIM ; Young Dae KIM

Journal of Cardiovascular Ultrasound.2007;15(1):23-26.

Dilated coronary sinus is often visualized on echocardiography in patients with right sided heart disease as well as with persistent left superior vena cava. We observed a case of markedly dilated coronay sinus caused by persistent left superior vena cava and severe tricuspid regurgitation. The diagnosis was made by transthoracic echocardiography with intravenous injection of agitated saline into both arm.
Arm ; Coronary Sinus* ; Diagnosis ; Dihydroergotamine ; Echocardiography ; Heart Diseases ; Humans ; Injections, Intravenous ; Tricuspid Valve Insufficiency* ; Vena Cava, Superior*

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Tentatively Diagnosed as Myxoma : Transit Thrombus Entrapped in Patent Foramen Ovale.

Sung Eun KIM ; Dae Gyun PARK

Journal of Cardiovascular Ultrasound.2007;15(1):19-22.

This case report presents a thrombus traversing a patent foramen ovale- impending paradoxical embolism, in 85 years old woman. It was tentatively diagnosed as atrial myxoma but after a month of anticoagulation therapy, completely resolved. So we can make diagnosis of impending paradoxical embolism retrospectively.
Aged, 80 and over ; Diagnosis ; Embolism ; Embolism, Paradoxical ; Female ; Foramen Ovale, Patent* ; Heart Septal Defects ; Humans ; Myxoma* ; Retrospective Studies ; Thrombosis*

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Diffuse Alveolar Hemorrhage due to Acute Mitral Regurgitation.

Ung KIM ; Geu Ru HONG ; Dong Hee KIM ; Sang Hee LEE ; Jong Seon PARK ; Dong Gu SHIN ; Young Jo KIM ; Bong Sup SHIM

Journal of Cardiovascular Ultrasound.2007;15(1):16-18.

Diffuse alveolar hemorrhage occurs from a variety of causes and mitral stenosis has been well known to cause hemoptysis. However, mitral regurgitation rarely can cause hemoptysis at presentation. A 38-year-old man who has been healthy was admitted to the hospital with massive hemoptysis. The patient underwent fiberoptic bronchoscopy which showed fresh blood throughout the bronchus of both lung and transbronchial biopsy showed chronic inflammation. All serologic and microbiologic markers were negative. On auscultation, grade 4 holosystolic murmur was incidentally heard at apex, the patient was examined by transthoracic 2-dimensional Doppler echocardiography which showed severe mitral regurgitation. Transesophageal echocardiography showed severe mitral regurgitation with A2 portion chordae rupture of anterior mitral leaflet. The patient was done with emergency mitral valve repair surgery and complete resolution of symptom and radiographic abnormalities thereafter.
Adult ; Auscultation ; Biopsy ; Bronchi ; Bronchoscopy ; Echocardiography ; Echocardiography, Doppler ; Echocardiography, Transesophageal ; Emergencies ; Hemoptysis ; Hemorrhage* ; Humans ; Inflammation ; Lung ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis ; Rupture

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External Compression of the Inferior Vena Cava by Tortuous Abdominal Aorta in the Elderly.

Geum Ha KIM ; Wook Jin CHUNG ; Mi Seung SHIN ; Kyu Jin OH ; Sang Jin LEE ; Sang Min PARK ; Seok Jae ZEON ; Byung Chun OH ; Jeong Ho KIM ; Eak Kyun SHIN

Journal of Cardiovascular Ultrasound.2007;15(1):13-15.

Budd-Chiari syndrome (BCS) is an uncommon disease caused by obstruction of hepatic venous outflow. This results in centrilobular congestion and necrosis, ultimately leading to fibrosis and cirrhosis of liver. Stenosis of the inferior vena cava (IVC) can be a one of causes of BCS. We report the a case of a 72-year-old woman who presented significant IVC stenosis due to extrinsic compression resulting by a tortuous abdominal aorta which was incidentally detected by echocardiography and successfully treated by stenting. To the date the extrinsic compression of IVC resulting from tortous aorta has never been reported to cause of BCS.
Aged* ; Aorta ; Aorta, Abdominal* ; Budd-Chiari Syndrome ; Constriction, Pathologic ; Echocardiography ; Estrogens, Conjugated (USP) ; Female ; Fibrosis ; Humans ; Liver ; Necrosis ; Stents ; Vena Cava, Inferior*

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Effects of Closure of the Arteriovenous Fistula on Left Ventricular Mass and Function in Kidney Transplantation Patients.

San KIM ; Jung Yun MOON ; Jung Eun HUH ; Jeoung Myung AHN ; Hyeon Gook LEE ; Kyoung Im CHO ; Tae Ik KIM

Journal of Cardiovascular Ultrasound.2007;15(1):8-12.

BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in kidney transplantion recipients. Enhanced cardiac load by the persistence of functioning AVF in posttransplant period is associated with LV hypertrophy and may adversely influence cardiac outcome. METHODS: To investigate the impact of AVF on LV mass and function in kidney transplant recipients, 46 patients with functioning AVF were randomly assigned to surgical closure of AVF (fistular closing group, FC, n=23) or maintenance of fistula (fistular maintenance group, FM, n=23). Serum creatinine of all participants was stable(1.4+/-0.3). Mean age was 46+/-11. Mean posttransplant month was 78+/-53 (12-161). Echocardiography and determination of N-terminal pro-BNP, cTnT and CRP were done at 0, 1 and 6 months in group 1 (FC), and at 0 and 6 months in group 2 (FM). RESULTS: Baseline echocardiographic indices of systolic and diastolic LV function such as EF, E/A, E/E' and Tei index were not significantly different between groups. In patients whose AVF was surgically closed, LV mass (247.7+/-76.8 to 235.2+/-66.5, p=0.015) and LV mass index (144.0+/-10.1 to 137.1+/-8.6, p=0.02) significantly reduced at one month after closure, and no further significant change was observed at 6 months. In two groups no significant change in LV systolic and diastolic performance indices were observed. BNP, cTnT and CRP did not differ between groups in baseline value and did not change after closure. CONCLUSION: We conclude that the persistence of functioning AVF in kidney transplantation recipients is associated with LVH, and which can be reduced by closure of fistula. As LVH is one of major determinants of cardiovascular outcome in transplant patients as well as in general population, it would be prudent to close the fistula in patients with stable graft function.
Arteriovenous Fistula* ; Cardiovascular Diseases ; Creatinine ; Echocardiography ; Fistula ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Kidney Transplantation* ; Kidney* ; Mortality ; Transplantation ; Transplants

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Echocardiographic Evaluation of Atrial Septal Defect Device Closure.

Jo Won JUNG

Journal of Cardiovascular Ultrasound.2007;15(1):1-7.

With further development of transcatheter techniques and improved occlusion devices, percutaneous closure has become the treatment of choice for secundum ASD. The Amplatzer septal occluder device is frequently used for ASD occlusion due to its straightforward implant technique and efficacy in occluding a wide range of ASD sizes. TEE is vital in the recognition of morphologic variations of the ASD and patient selection. It allows clear visualization of the defect and the device during the procedure, precise measurements of stretch diameters, guiding of deployment, and stable positioning of the device. This is especially important in patients with large ASDs or multiple ASDs and those with atrial septal aneurysm. With TEE, incorrect positioning of the device can be detected while it is still screwed to the delivery cable, which allows its early redeployment, before any complications occur. Compared with the patients undertaken surgical repair, the left ventricular function using strain rate imaging was preserved after the device closure. Echocardiographic evaluation for ASD device closure is essential in patient selection, during procedure, after occlusion, and long term follow-up.
Aneurysm ; Echocardiography* ; Follow-Up Studies ; Heart Septal Defects, Atrial* ; Humans ; Patient Selection ; Septal Occluder Device ; Ventricular Function, Left

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A Case of Hemolytic Anemia Following Mitral Valve Repair.

Myoung Ki OH ; Woo Shik KIM ; Sun Young KIM ; Jong Hyeok PARK ; Sun Ok KWON ; Jong Chun NAH ; Ju Won CHOI ; Wook Hyun CHO ; Yong In KIM ; Suk Koo CHOI

Journal of Cardiovascular Ultrasound.2007;15(2):63-62.

Hemolytic anemia is one of the findings representative of prosthesis dysfunction after valve surgery. A 67-year-old man, who underwent mitral annular ring plasty one week ago, was admitted with shortness of breath and fatigue. Hematological studies revealed a Coombs'-negative hemolytic anemia with a hemoglobin 7.9 g/dl, hematocrit of 17.1%, haptoglobin of 1.0 mg/dl, LDH 5148 U/L, total bilirubin of 3.1 mg/dl (direct of 0.71 mg/dl), and a peripheral blood smear demonstrating mechanical hemolysis with red cell fragmentation. Transesophageal echocardiogram revealed a turbulent jet of mitral regurgitation hitting the annuloplasty ring. The patient returned to the operating room for mitral valve replacement, and thereafter which the hemolytic anemia resolved.
Aged ; Anemia, Hemolytic* ; Bilirubin ; Dyspnea ; Fatigue ; Haptoglobins ; Hematocrit ; Hemolysis ; Humans ; Mitral Valve Insufficiency ; Mitral Valve* ; Operating Rooms ; Prostheses and Implants

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A Case of Multiple Myeloma with Pulmonary Thromboembolism Diagnosed by Transthoracic Echocardiography.

Jeong Myung AHN ; Hye Jung JANG ; Seoul Jung AK ; Jung Eun HUH ; Jung Yun MOON ; Hyeon Gook LEE ; Kyoung Im CHO ; Tae Ik KIM

Journal of Cardiovascular Ultrasound.2007;15(2):59-62.

Cancer is a major risk factor for pulmonary thromboembolism. Occasionally, the thromboembolic event occurs before the diagnosis of cancer. We report a rare case of massive pulmonary thromboembolism with multiple myeloma diagnosed by transthoracic echocardiography.
Diagnosis ; Echocardiography* ; Multiple Myeloma* ; Pulmonary Embolism* ; Risk Factors

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A Case of Infundibular Pulmonic Stenosis in Adult.

Hui Jeong HWANG ; Dong Hyun LEE ; Sang Hee KIM ; Tae Seok KIM ; Hyuk Min KWON ; Yoon Seok CHOI ; Chul Soo PARK ; Yong Seog OH ; Ho Joong YOUN ; Wook Sung CHUNG

Journal of Cardiovascular Ultrasound.2007;15(2):55-58.

A 47-year-old woman was admitted for evaluation of exertional dyspnea (NYHA II-III) that was lasting for 20 years. On physical examination, a grade III systolic murmur in the left second intercostal spaces was detected. The chest Xray showed mild cardiomegaly. ECG showed biatrial and biventricular hypertrophy. Transthoracic echocardiography showed severe infundibular pulmonic stenosis (pressure gradient=174 mmHg), moderate tricuspid regurgitation (jet velocity=6.6 m/sec) with biatrial enlargement and biventricular hypertrophy. Transesophageal echocardiogram showed severe infundibular pulmonic stenosis. Right ventriculography and catheterization revealed a pressure gradient between pulmonary artery and right ventricle (178/6 mmHg). We reported a rare case of infundibular pulmonic stenosis with intact ventricular septum in adult with literatures.
Adult* ; Cardiomegaly ; Catheterization ; Catheters ; Dyspnea ; Echocardiography ; Electrocardiography ; Female ; Heart Ventricles ; Humans ; Hypertrophy ; Middle Aged ; Physical Examination ; Pulmonary Artery ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Thorax ; Tricuspid Valve Insufficiency ; Ventricular Septum

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