BACKGROUND: Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection. METHODS: Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months. RESULTS: No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7 ± 4.2 min vs. 17.9 ± 5.9 min, P < 0.05) and the amount of contrast agent (3.0 ± 5.1 mL vs.18.1 ± 3.4 mL, P < 0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0 ± 3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P = 0.88). CONCLUSIONS Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure.
Aged ; Atrial Fibrillation ; diagnostic imaging ; surgery ; Contrast Media ; Cryosurgery ; methods ; Echocardiography, Three-Dimensional ; methods ; Echocardiography, Transesophageal ; methods ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; diagnostic imaging ; surgery ; Treatment Outcome

The authors encountered a 4-month-old, female Shiba dog weighing 4.0 kg, who had been exhibiting abdominal distension and increasing ascites for 2 months. She was brought for further examination and treatment with the chief complaints of ascites and dyspnoea during sleep. The dog was diagnosed with ascites caused by cor triatriatum dexter based on the physical and imaging findings. Under general anaesthesia, she was treated with hybrid balloon dilation under transoesophageal echocardiography guidance. Her postoperative recovery was quite rapid and uneventful. This method appears to be a useful, new, and less-invasive treatment option for cor triatriatum dexter.
Animals ; Ascites ; Cor Triatriatum ; Dogs ; Echocardiography ; Echocardiography, Transesophageal ; Female ; Heart Defects, Congenital ; Humans ; Infant ; Methods

No abstract available.
Aged ; *Cardiac Catheterization/instrumentation ; Computed Tomography Angiography ; Coronary Angiography/methods ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal ; Female ; Heart Septal Defects, Atrial/diagnostic imaging/*therapy ; Humans ; Septal Occluder Device ; Treatment Outcome

Aortic Valve Stenosis ; diagnostic imaging ; surgery ; Cardiac Surgical Procedures ; methods ; Echocardiography, Transesophageal ; methods ; Humans ; Infant, Newborn ; Male ; Mitral Valve ; diagnostic imaging ; surgery

BACKGROUNDTransesophageal echocardiography (TEE) is a well-established method for detecting and diagnosing heart tumors. In contrast, its role in assessing the presence, growth and evidence of malignant tumors originating from mediastinal sites remains unclear. The aim of this study was to compare the diagnostic impact of TEE and transthoracic echocardiography (TTE) for determining the localization, growth and malignancy of adult mediastinal tumors (MTs).

METHODSIn a prospective and investigator-blinded study, we evaluated 144 consecutive patients with MT lesions to assess the diagnostic impact of TEE and TTE for detecting the presence of tumors spreading both inside and outside of the heart and for determining infiltration and invasion using pathological examination results as a reference.

RESULTSAll tumor lesions were diagnosed and carefully evaluated by biopsy. Biopsy revealed malignant tumors in 79 patients and benign tumors in 65 patients. When compared to histological findings, TEE predicted malignancy from the presence of tumors spreading both inside and outside of the heart and from infiltration and invasion in 49/79 patients (62.0%). TTE predicted malignancy in only 8/79 patients (10.1%, P < 0.005). TEE visualized tumor lesions in 130 patients (90.3%) while the TTE visualized tumor lesions in 110 patients (76.4%) and was less effective at detecting MT lesions (P < 0.001). TTE and TEE could detect anterior MTs and adequately verified MTs (P > 0.05); TEE detected medium MTs better than TTE (P < 0.001).

CONCLUSIONSTEE is effective and superior to TTE for predicting the localization and growth of MTs as well as for accessing evidence of tumor malignancy. TTE and TEE were able to detect anterior MTs; TEE was able to detect medium MT better than TTE.

Adult ; Aged ; Echocardiography, Transesophageal ; methods ; Female ; Heart Neoplasms ; diagnostic imaging ; Humans ; Male ; Mediastinal Neoplasms ; diagnostic imaging ; Middle Aged ; Prospective Studies ; Young Adult

Adult ; Aged ; Aged, 80 and over ; Echocardiography, Transesophageal ; methods ; Female ; Foramen Ovale, Patent ; diagnosis ; Humans ; Male ; Middle Aged

PURPOSE: Venous air embolism (VAE) is characterized by the entrainment of air or exogenous gases from broken venous vasculature into the central venous system. No study exists regarding the effect of patient positioning on the incidence of VAE during abdominal myomectomy. The purpose of this study was to assess the incidence and grade of VAE during abdominal myomectomy in the supine position in comparison to those in the head-up tilt position using transesophageal echocardiography. MATERIALS AND METHODS: In this study, 84 female patients of American Society of Anesthesiologist physical status I or II who were scheduled for myomectomy under general anesthesia were included. Patients were randomly divided into two groups: supine group and head-up tilt group. Transesophageal echocardiography images were videotaped throughout the surgery. The tapes were then reviewed for VAE grading. RESULTS: In the supine group, 10% of the patients showed no VAE. Moreover, 10% of the patients were classified as grade I VAE, while 50% were categorized as grade II, 22.5% as grade III, and 7.5% as grade IV. In the head-up tilt group, no VAE was detected in 43.2% of the patients. In addition, 18.2% of the patients were classified as grade I VAE, 31.8% as grade II, and 6.8% as grade III; no patients showed grade IV. VAE grade in the head-up tilt group was significantly lower than that in the supine group (p<0.001). CONCLUSION: The incidence and grade of VAE in the head-up tilt group were significantly lower than those in the supine group during abdominal myomectomy.
Abdomen/pathology ; Adult ; Echocardiography, Transesophageal ; Embolism, Air/epidemiology/*etiology ; Female ; Humans ; Incidence ; Middle Aged ; Myoma/pathology/*surgery ; *Posture ; Supine Position ; Uterine Myomectomy/adverse effects/*methods ; Uterus/pathology/ultrasonography ; Veins/*ultrasonography

OBJECTIVETo evaluate the role of intraoperative transesophageal echocardiography (TEE) during robotic atrial myxoma excision.

METHODSThirty-eight consecutive patients undergoing robotic atrial myxoma excision from September 2007 to August 2012 were enrolled in the study. During the procedure, TEE was performed to document the myxoma position, its attachment, and hemodynamic information before cardiopulmonary bypass (CPB). During establishment of peripheral CPB, TEE was used to guide placement of the cannulae in the inferior vena cava (IVC), superior vena cava (SVC), and ascending aorta (AAO). After weaning from CPB, TEE was performed to evaluate the effect of the procedure.

RESULTSThe accuracy of TEE for the position or its attachment of the myxoma was 100%. All the cannulae in the SVC, IVC and AAO were located in correct position. In all patients, TEE confirmed successful excision.

CONCLUSIONIntraoperative TEE is a valuable adjunct in patients undergoing robotic atrial myxoma excision.

Adolescent ; Adult ; Aged ; Echocardiography, Transesophageal ; methods ; Female ; Heart Neoplasms ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Myxoma ; diagnostic imaging ; surgery ; Robotics ; Young Adult

OBJECTIVE: To discuss the preoperative, intraoperative, and postoperative application of echocardiography in mini-invasive surgical device closure of secundum atrial septal defects, including those special and difficulty-occluded defects. METHODS: We performed mini-invasive surgical device closure of secundum atrial septal defects on 287 patients. Before the surgery, transthoracic echocardiography was applied for screening; during the surgery we reassessed the sizes of the defects and their remaining margins, designated the suitable occluders, and guided the placement of the occluders by multiplane transesophageal echocardiography. The patients were postoperatively followed up at regular intervals by multiplane transesophageal echocardiography (MTEE) which was employed to assess the therapeutic efficacy. RESULTS: Out of the 287 atrial septal defects, 276 (96.17%) were successfully closed. There were 37 porous defects and 23 cases with short posterior-inferior margin of defects. Follow-ups at intervals showed the occluders stayed firmly and echoed clearly. No notable residual shunt or valve regurgitation was observed. CONCLUSION Echocardiography plays a vital and reliable role in mini-invasive surgical device closure of secundum atrial septal defects, especially those special and difficulty-occluded defects.
Adolescent ; Child ; Child, Preschool ; Echocardiography, Transesophageal ; methods ; Female ; Heart Septal Defects, Atrial ; surgery ; Humans ; Infant ; Male ; Minimally Invasive Surgical Procedures ; methods ; Septal Occluder Device ; Ultrasonography, Interventional

Transcatheter aortic valve implantation and transcatheter mitral valve repair (MitraClip) procedures have been performed worldwide. In this paper, we review the use of two-dimensional and three-dimensional transesophageal echo for guiding transcatheter aortic valve replacement and mitral valve repair.
Aged ; Aged, 80 and over ; Aortic Valve Stenosis/*therapy/*ultrasonography ; Balloon Valvuloplasty ; Bioprosthesis ; *Cardiac Catheterization/adverse effects/instrumentation ; *Echocardiography ; Echocardiography, Doppler, Color ; Echocardiography, Three-Dimensional ; Echocardiography, Transesophageal ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/adverse effects/instrumentation/*methods ; Humans ; Mitral Valve Insufficiency/*therapy/*ultrasonography ; Predictive Value of Tests ; Prosthesis Design ; Severity of Illness Index ; Surgical Instruments ; Ultrasonography, Interventional/*methods