Showing papers on "Ostium published in 1987"

Percutaneous balloon valvuloplasty of mitral stenosis aided by cardiac ultrasound

Abstract: Recent reports1–6 have established the feasibility of percutaneous balloon dilation of stenotic mitral valves. The standard transseptal technique used for this procedure was modified by Lock et al2 to include dilation with an 8-mm balloon catheter of the ostium created in the atrial septum. Successful transseptal delivery of the larger balloons required for mitral valve dilation depends on an adequate-sized atrial septostomy; too small a defect may interfere with advancement of the valvular dilation catheter toward the mitral orifice. The present report describes the manner in which 2-dimensional (2-D) echocardiography was successfully used to monitor delivery of the valvular dilation catheter across the atrial septum and through the mitral orifice.

Hysteroscopy for evaluation of tubal ostium pathology

Abstract: A comparison between hysterosalpingography and hysteroscopy in the evaluation of tubal ostium pathology is presented by the authors. They stress in particular the role of hysteroscopy in this evaluation.

Unusual cases of coronary death

Abstract: Stenosing coronary artery sclerosis is the most common cause of sudden unexpected death. In this report we present three exceptions: 1. A mycotic coronary aneurysm ruptures and results in pericardial tamponade; 2. in a young woman Takayasu aortitis encroaches on the ostium and mainstem of the left coronary; 3. fibromuscular dysplasia of the right coronary artery causes death in a 56-year-old male.

Diagnostic contribution of ultrasonic diagnosis coupled with pulsed Doppler combined with continuous Doppler to the exploration of the vertebral arteries of atherosclerotic patients. Preliminary report

Abstract: Velocimetric exploration by continuous emission Doppler is still essential for non-invasive evaluation of vertebral circulation but it does not provide morphologic data. Results were compared of exploration with combined continuous emission Doppler and a Duplex examination (sectorial scanning ultrasound imaging coupled with pulsed emission Doppler) and data from arteriography of 186 vertebral arteries in patients, mean age 57 years, admitted for exploration of a cerebral ischemic accident or a cervical murmur. The Duplex examination allowed identification of proximal segment (VI) in 98% of permeable vertebral arteries. The ostium of the vertebral artery was more difficult to visualize because of possible tortuosities, of sometimes a too posterior or intrathoracic localization or of a short neck. Nevertheless the vertebral ostium was identified in 78% of cases on the right and 48% on the left. The Duplex examination demonstrated sensitivity of 72% and specificity of 98% for detection of proximal stenosis of vertebral artery, and its sensitivity was therefore twice as sensitive as continuous emission Doppler for detection of stenoses of less than 50%. The Duplex examination should complete data from continuous emission Doppler by providing an evaluation of vertebral artery diameter and information on presence and characters of an elongation or stenosis. In this way, 9 atheromatous plaques not identified on arteriography were detected by ultrasound imaging. Similarly, the Duplex examination is particularly useful for identification of a hypoplastic vertebral artery, to distinguish the specific lesions of the subclavian artery from those extending onto vertebral ostium, and to characterize ostial lesions when these are accessible to examination.(ABSTRACT TRUNCATED AT 250 WORDS)

[Isolated ostial stenosis: a peculiar anatomic form of coronary insufficiency in women].

Abstract: We report 5 cases of isolated ostial stenosis of the left main coronary vessel. Isolated ostial stenosis occurs preferentially in young or middle aged women for whom coronary insufficiency is usually not a serious threat. Patients with this type of lesion have characteristically severe angina of relatively recent onset. The condition may be difficult to diagnose at angiography, but a fall in pressure when the tip of the catheter enters the coronary lumen beyond the stenosis, a lack of reflux of the contrast medium into the sinus of Valsalva during intracoronary injection and its persistence in the coronary vessel should alert the investigator. A pathological study of 3 cases revealed typical atheromatous lesions in 2 patients (with extension of an aortic plaque to the left coronary ostium in one, and atheroma localized on the ostium in the other) and a purely fibrous lesions in a patient who had undergone thoracic radiotherapy 5 years previously. Although relatively rare, stenosis must be diagnosed in view of its sombre spontaneous prognosis (one patient died 3 days after coronary arteriography), of the risk of underestimating its frequency, and of the hazards of selective coronary catheterization in such patients (one of our patients died 15 minutes after coronary exploration).