Coronary Artery Diseases
This chapter, Coronary Artery Disease, covers ischemic MR, LV apex akinesis having Dor’s procedure, and a post myocardial infarction VSD.
- PDF / 1,285,810 Bytes
- 11 Pages / 504.57 x 720 pts Page_size
- 66 Downloads / 198 Views
Coronary Artery Diseases
Abstract
This chapter, Coronary Artery Disease, covers ischemic MR, LV apex akinesis having Dor’s procedure, and a post myocardial infarction VSD. Complications of myocardial infarction must be aware of besides the wall motion. When evaluating ventricular function in the perioperative period, changes in preload, pacing, respiration, and performance are dynamic and are affected significantly by the physiologic changes.
6.1
Ischemic Mitral Regurgitation Having Mitral Repair
A 61-year-old man suffered from chest tightness. Triple coronary artery disease with recent myocardial infarction was diagnosed at another
hospital. Auscultation: regular heart beat with a grade 3 murmur over apex. ECG: sinus rhythm, first degree AV block, clockwise rotation and non-specific ST-T change. Chest X ray: cardiomegaly with LV enlargement. Operation: CABG x4 (LIMA to diagonal branch, SVG to LAD, SVG to OM and SVG to RCA) and MV repair.
Electronic supplementary material The online version of this chapter (doi:10.1007/978-981-10-0587-9_6) contains supplementary material, which is available to authorized users.
© Springer Science+Business Media Singapore 2016 W.-H. Yin, M.-C. Hsiung, Atlas of Perioperative 3D Transesophageal Echocardiography, DOI 10.1007/978-981-10-0587-9_6
109
6
110
Fig. 6.1 Two-dimensional transesophageal echocardiography (2D TEE), long-axis view, showed a small apical anterior septal aneurysm (yellow arrows) and “sea gull” sign of anterior mitral leaflet (white arrow) which caused by ischemic tethering of leaflet with chordae
Coronary Artery Diseases
Fig. 6.4 3D TEE, long-axis view, showed “sea gull” sign of anterior mitral leaflet (arrow) which caused by ischemic tethering of leaflet with chordae
Fig. 6.2 2D TEE color Doppler, long-axis view, showed severe ischemic MR (arrow) Fig. 6.5 3D TEE color Doppler, long-axis view, showed severe ischemic MR
Fig. 6.3 3D TEE, long-axis view, showed a small apical anterior septal aneurysm (arrows)
Fig. 6.6 2D TEE, long-axis view, status post CABG and MV repair, showed normal MV function
6.1
Ischemic Mitral Regurgitation Having Mitral Repair
111
Fig. 6.7 2D TEE color Doppler, long-axis view, status post CABG and MV repair, showed mild MR Fig. 6.9 3D TEE color Doppler, long-axis view, status post CABG and MV repair, showed mild MR
Tips Examination of mitral leaflet, subvalvular apparatus, and ventricular function are all essential to evaluate the etiology of MR.
Fig. 6.8 3D TEE, long-axis view, status post CABG and MV repair, the physic ring (arrow) was seen
6
112
6.2
Left Ventricular Apex Akinesis with Thrombus Having Dor Procedure
A 24-year-old man with gout suffered from severe chest pain, cold sweating, vomiting and mild dyspnea. Emergent cardiac catheterization showed LAD coronary aneurysm and thrombus
Coronary Artery Diseases
impaction. But PTCA and thrombus suction failed. Auscultation: regular heart beat without significant murmur. ECG: sinus rhythm and old anterior wall myocardial infarction with aneurysm formation. C
Data Loading...
