Transthoracic Echocardiography

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My Approach To

My Approach to Transseptal Mitral Valve-In-Valve

Andrea de Andrade Vilela et al. Antonio Tito Paladino Filho Maria Estefânia Bosco Otto Vanessa Andreoli Esmanhoto

Introduction

The percutaneous treatment of heart valve disease is a subject of great interest in cardiology. Percutaneous aortic valve implantation, first performed in 2002 by Alan Cribier, paved the way for transcatheter treatment of the mitral valve.

The first valve-in-valve (VIV) procedures were performed to treat deteriorated bioprosthetic valves in the aortic position. ^, In 2009, the group led by Dr. John Webb published the first successful case of mitral VIV. Since then, mitral VIV has been performed in numerous centers worldwide.

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A Deceiving Aorta

Helder Santos et al. Hugo Miranda Inês Almeida Mariana Santos … Samuel Almeida Lurdes Almeida

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Artigo Original

Evolutive echocardiographic study of the structural and functional heart alterations in obese individuals after bariatric surgery

Luciana de Cerjat Bernardes P. Cunha et al. Cláudio L. Pereira da Cunha Admar Moraes de Souza Nelson Chiminacio Neto … Ricardo Soares Pereira Henrique Lacerda Suplicy

OBJECTIVE: To evaluate with Doppler echocardiography the reversibility of structural and hemodynamic changes in obeses after bariatric surgery. METHODS: Twenty-three patients (19 women = 82.6%) were studied. Mean age was 37.9 years. All subjects had Class III or Class II obesity with comorbidity and were submitted to bariatric surgery. Clinical and echocardiographic evaluation were performed preoperatively, in 6 months and 3 years after surgery. RESULTS: Preoperatively, the mean weight and blood pressure (BP) were respectively 128.7± 25.8 kg and 142.2 ± 16.2 / 92.2 ± 10.4 mmHg. Postoperatively, they showed important body weight reduction in 6 months (97.6 ± 18.3 kg) and 3 years (83.6 ± 13.5 kg), and BP reduction in 6 months (128.5 ± 16.1/80.7 ± 9.9 mmHg) that remain stable in 3rd year. On echocardiogram, preoperatively, there was hypertrophy of the septum and posterior wall associated with normal diastolic dimension; the predominant LV geometric pattern was concentric remodeling (74%). At six months, thinning of the ventricular septum and LV posterior wall, and increase in LV diastolic dimension were demonstrated. At 3rd year, the predominant LV pattern was normal (69%), with reduction of LV mass and LV mass/height² index. We noticed improved diastolic function, with an increased E/A ratio and a decreased LV isovolumic relaxation time. The Myocardial Performance Index was obtained retrospectively in 13 patients and improved in 6 months. There was an increase of the ejection time in 6 months and an elevation of the ejection fraction in 3rd year, suggesting improvement of the LV systolic function. CONCLUSION: The weight loss obtained with bariatric surgery promotes both structural and functional myocardial changes that improve cardiac performance.

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My Approach to Transseptal Mitral Valve-In-Valve

Introduction

A Deceiving Aorta

Evolutive echocardiographic study of the structural and functional heart alterations in obese individuals after bariatric surgery

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)