Document Detail


Rapid onset and dissipation of left atrial spontaneous echo contrast during percutaneous balloon mitral valvotomy.
MedLine Citation:
PMID:  9539475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Thromboembolism after percutaneous balloon mitral valvotomy (PBMV) has been attributed to dislodement of preexisting thrombus during transseptal puncture and instrumentation of the left atrium. The occurrence of thromboembolic events after PBMV in the absence of demonstrable left atrial thrombus before PBMV suggests that thrombus might form during the procedure. Spontaneous echo contrast (SEC) is a swirling pattern of blood echogenicity that is a marker of blood stasis in the left atrium. Exacerbation of left atrial SEC during PBMV may be indicative of an increased thromboembolic risk. METHODS: Transesophageal echocardiography was performed during PBMV in 20 patients with mitral stenosis. Grades of severity of left atrial SEC [0 (nil) to 4+ (severe)] were allocated before and after each balloon inflation. RESULTS: Before PBMV, SEC was present in 17 patients. New SEC or increased severity of SEC was observed during 49 of 56 balloon inflations. SEC was unchanged after six deflations, decreased after 14 deflations, and disappeared after 36 deflations. The mean times to onset and dissipation of SEC after balloon inflation and deflation were 3.1+/-1.5 and 3.9+/-1.6 seconds, respectively. After successful PBMV, SEC was unchanged in three patients, decreased in one, and resolved in 13. CONCLUSIONS: SEC is a dynamic and acutely reversible phenomenon that is highly sensitive to changes in left atrial hemodynamic conditions. Left atrial blood stasis induced by balloon inflation may promote thrombogenesis during PBMV.
Authors:
D Fatkin; P Roy; A Sindone; M Feneley
Related Documents :
9120165 - Echocardiographic determinants of clinical course in infants with critical and severe p...
3975425 - Electrolysis for recanalization of urinary collecting system obstructions: a percutaneo...
10769995 - Acute aortic thrombosis after intra-aortic balloon pumping.
9176545 - Oesophageal plastic repair for symptomatic ballooning following circular oesophageal my...
15135695 - Randomized comparison of balloon angioplasty versus silicon carbon-coated stent implant...
18481125 - Renewed endovascular repair for recurrent acute abdominal aortic aneurysm.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  135     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-04-24     Completed Date:  1998-04-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  609-13     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Department, St. Vincent's Hospital, Sydney, Australia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / complications
Atrial Flutter / complications
Balloon Dilatation / adverse effects*
Contrast Media*
Echocardiography, Doppler
Echocardiography, Transesophageal
Female
Heart Atria / physiopathology,  ultrasonography*
Humans
Male
Middle Aged
Mitral Valve Stenosis / complications,  therapy*,  ultrasonography
Rheumatic Heart Disease / complications,  therapy,  ultrasonography
Risk Factors
Severity of Illness Index
Thromboembolism / etiology
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Aortic stiffness in young patients with heterozygous familial hypercholesterolemia.
Next Document:  Reduced pulmonary clearance of endothelin-1 in pulmonary hypertension.