Rajat S. Sanyal

Transesophageal biplane echocardiographic imaging: technique, planes, and clinical usefulness.

The technique of examination, imaging planes, and the clinical utility of transesophageal biplane echocardiography are described.

Comparison of Multiplane and Biplane Transesophageal Echocardiography in the Assessment of Aortic Stenosis

The aim of the study was to compare the accuracy of multiplane transesophageal echocardiography (TEE) with the more conventional biplane technique in the direct assessment of aortic valve area in patients with aortic stenosis. Short-axis images of the aortic valve adequate for measuring aortic valve area were obtained in all 81 patients studied by multiplane TEE but in only 56 of 64 patients (88%) using the biplane approach. The correlation coefficient for aortic valve area determined by multiplane TEE (r = 0.89; SEE = 0.04 cm2) was higher (p < 0.01) than biplane TEE (r = 0.74; SEE = 0.06 cm2). Correlations were higher for bicuspid valves (multiplane, r = 0.93; biplane, r = 0.75) than tricuspid valves (multiplane, r = 0.87; biplane, r = 0.75). Our study has demonstrated the superiority of multiplane TEE to both biplane TEE and transthoracic echocardiography (TTE) in the direct evaluation of aortic valve area in patients with aortic stenosis.

Usefulness of transesophageal echocardiography in the diagnosis of ventricular septal rupture secondary to acute myocardial infarction

Abstract Ventricular septal rupture is a rare complication of acute myocardial infarction and is usually fatal if not surgically repaired. 1 Two-dimensional 2 and color Doppler 3–6 surface echocardiography are sensitive in its detection, but their main limitation is the presence of small acoustic windows in some patients. However, the recently introduced technique of transesophageal echocardiography has circumvented this limitation to a large extent. This study evaluates the usefulness of color Doppler transesophageal echocardiography in the diagnosis of ventricular septal rupture after acute myocardial infarction.

Transesophageal echocardiographic assessment of congenital coronary artery to coronary sinus fistulas in adults

Coronary artery to coronary sinus fistula is a rare congenital disorder. Aortography and selective coronary angiography are currently the diagnostic modes of choice for the evaluation of congenital coronary artery fistulas, but recent reports have demonstrated the usefulness of noninvasive techniques.1–3 We describe 3 patients in whom the relatively new technique of transesophageal echocardiography was found useful not only in the diagnosis and precise localization of these lesions but also in the intraoperative evaluation of the surgical repair (Table I, Figures 1 to 3). All transthoracic 2-dimensional and color Doppler examinations were done in the standard manner using a commercially available system and a 2.0 or 2.5 MHz transducer.4 Intraoperative transesophageal echocardiographic studies were also performed in the standard manner5 using a 5 MHz transducer (Hewlett-Packard 77760A system for patients 1 and 2 and Aloka 870 biplane system for patient 3). The proximal coronary arteries were examined using the standard basal shortaxis view6 and the coronary sinus outlined in the right ventricular inflow plane.

Usefulness of Transesophageal Echocardiography in the Assessment of Aortic Graft Dehiscence

The diagnosis and site of graft dehiscence determined by transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), and aortography in 6 patients, and by computed tomography (CT) scan in 3 patients were compared with surgery. Sensitivity of TEE was 100%, aortography 83%, CT scan 67%, and TTE 33%; TEE accurately identified severe aortic regurgitation (3), graft narrowing (2), distal aortic dissection (1), and a fistulous communication between the aortic root and the right ventricle (1) when compared with surgery or aortography.

Transesophageal Echocardiographic Examination of Left‐Sided Superior Vena Cava and Azygos and Hemiazygos Veins

In the present study, we describe our experience in the delineation of the left‐sided superior vena cava, azygos vein, and hemiazygos vein, using transesophageal echocardiography. (ECHOCARDIOGRAPHY, Volume 8, November 1991)

Assessment of Aortic Coarctation and Collateral Circulation By Biplane Transesophageal Echocardiography

Our experience in using biplane transesophageal echocardiography in the assessment of coarctation of the aorta is described.

Quadricuspid Aortic Valve Diagnosed by Multiplane Transesophageal Echocardiography

The usefulness of multiplane transesophageal echocardiography in the diagnosis of quadricuspid aortic valve is described.

Transesophageal Echocardiographic Findings in Complete Unilateral Anomalous Pulmonary Venous Connection of Right Lung to Right Atrium

Transesophageal echocardiographic findings in a patient with anomalous drainage of both right‐ sided pulmonary veins into the right atrium are described. The atrial septum was intact and the left‐ sided veins connected normally with the left atrium.

Transthoracic and transesophageal echocardiographic diagnosis of severe subaortic obstruction produced by an abscess cavity

1. Hollander JE, Quick G. Aortoesophageal fistula: a comprehensive review of the literature. Am J Med 1991;91:279-8’7. 2. Bogey, WM Jr, Thomas JH, Hermreck AS. Aortoesophageal fistula: report of a successfully managed case and review of the literature. J Vast Surg 1992;16:90-5. 3. von Oppell UO, de Groot M, Thierfelder C, Zilla P, Ode11 JA. Successful management of aortoesophageal fist& due to thoracic aortic aneurysm. Ann Thorac Surg 1991;52:1168-70. 4. West AB, Nolan N, O’Briain DS. Benign peptic ulcers penetrating pericardium and heart: clinicopathological features and factors favoring survival. Gastroenterology 1988;94:1478-87. 5. Fmelli FC, Piasio M, Mahfood S, Keshishian JM, Golocovsky M. Esophageal rupture complicated by a gastrocardiac fistula: review of the literature and report of a successfully treated case. Ann Thorac Surg 1989;48:582-3. 6. Grande JP, Pelliika PA, Edwards WD, Puga FJ. Cardiogastric fistula occurring 9 years after resection of left ventricular aneurysm. Int J Cardial 1990;27:327-31. 7. Bell MD, Tate LG, Hensley GT. Esophageal-atrial fistula resulting in systemic “meat and vegetable” emboli. Am J Forensic Med Path01 1992;13:137-41. 8. Mott JM, Austin GE. Cerebral embolization resulting from esophageal-atrial fistula. Arch Intern Med 1976;136:718-20. Transthoracic and transesophageal echocardiographic diagnosis of severe subaortic obstruction produced by an abscess cavity