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“Lightning The Heart” with 3D Echo: Transillumination of a Prosthetic Mitral Valve Dehiscence

Mariana Ribeiro Silva et al. Ana Isabel Azevedo Francisco Sampaio José Ribeiro Ricardo Fontes-Carvalho

Case 1

A 55-year-old man underwent mitral valve replacement with a caged-ball prosthesis (3M Starr-Edwards) at the age of 29. He was admitted with acute heart failure, functional New York Heart Association (NYHA) class III. Transthoracic echocardiography (TTE) showed a moderate-severe mitral periprosthetic leak; 3D-transesophageal echocardiography (TOE) showed prosthesis dehiscence, with a severe periprosthetic leak (). TI improved depth perception and accurate definition of the degree of prosthetic dehiscence, demonstrating a disinsertion of the mitral prosthesis, involving more than 50% of mitral circumference (; ).

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Original Article

Reliability of the interpretation of coronary angiography by the simple visual method

Jorge Augusto Nunes Guimarães et al. Edgar Guimarães Victor Maria do Rosário de Britto Leite José Maria Pereira Gomes … Edgar Victor Filho Jesus Reyes Liveras

OBJECTIVE: Evaluation of inter and intraobserver reproducibility of by the visual method interpretation of cineangiogram in a clinically based context. METHODS: Five interventional cardiologists analyzed 11 segments of 8 coronary cineangiograms at a two month apart sessions. The percent luminal reduction by the lesions were analyzed by two different classifications: in one (A) the lesions were graded in 0% = absent, 1-50% = mild, 51 – 69 = moderate, and > or = 70% = severe; the other classification (B) was a dichotomic one : or = 70%=significant lesions. The agreement were measured by the kappa (k) index. RESULTS: Interobserver agreement was moderate for classification A (1st measurement, k = 0.36 — 0.63, k m = 0.49; 2nd measurement, k = 0.39-0.68, k m = 0.52) and good for classification B (1st measurement, k = 0.55-0.73, k m = 0.63; 2nd measurement, k = 0.37-0.82, k m = 0.61). Intraobserver levels of agreement were k = 0.57-0.95 for classification A and 0.62-1.0 for classification B. CONCLUSION: The higher level of reproducibility obtained by adopting the dichotomous criteria usually considered for ischemic limits demonstrates that in the present clinical context, the reliability of the simple visual method is adequate for the identification of patients with clinically significant lesions and candidates for myocardial revascularization procedures.

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“Lightning The Heart” with 3D Echo: Transillumination of a Prosthetic Mitral Valve Dehiscence

Case 1

Reliability of the interpretation of coronary angiography by the simple visual method

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)