European multicente~-clinic~ trials the new ultrasound contrast medium Echo~ist -was used in conventional contrast-echocardiographic examinations of right heart cavities in a total of more than 900 patients and in colour-flow imaging (CFI) in more than 300 cases including more than 200 shunt-patients. The overall ~o].erance of multiple intravenous injections of Bchovist was very good. No drug-related severe side effects or side effects needing special treatment occurred. No changes of observed parameters of blood chemistry were found.In conventional echocardiography diagnostic ~dvantages of echogenic blood-labelling with Echovist-were found i~ more than 70 % of the examinations. In CFI Echovist'" led to a strong enhancement of the Dopplersignal intensity, which allowed colour flow imaging in such patients in whom due to low S/N ratio only ~oor or no flow imaging was possible without Echovist . Flow model studies and clinical tria~ confirmed that enhanced flow imaging with Echovist "~ will compensate for interindividual variations due to attenuation, Preliminary results of ongoing studies suggest that the agent leads to improvements in quantitative analysis of CW-and 2D-data.Conclusion: The galact~e-microparticle and microbubble-suspension Bchovist-is well tolerated and leads to a dose-dependent blood-echosignal enhancement. This results in i) excellent observabi]ity of he~dynamics in conventional echocardiography, 2) improved S/N ratio in CFI 3) improved quantitative analyses. REGIONAL MYOCARDIAL PERFUSION USING CONTRAST ECHOCARDIOGRAPHY DURING CORONARY ARTERY SURGERYIntraoperative echocardiography was performed in 20 adult patients undergoing coronary artery bypass grafting (CABG). With IRB approval, sonicated Renografin 76 (4ml) was selectively injected into each completed vein graft (2ml/graft). Simultaneous two-dimensional echocardiography demonstrated transmural contrast enhancement of the region supplied by the graft/distal coronary artery. The geometry of regional contrast distribution correlated well with the preoperative assessment of coronary size and distribution. Rapid contrast washout indicated normal graft function in all grafts. The degree of regional opacification during injection indicated that there was little competitive native coronary perfusion.This was consistent with appropriate anastomotic site selection (distal to physiologically significant stenoses) in all instances. No adverse effects (need for inotropic support, perioperative MI, elevation of CPK or CPK-MB, or neurological, bleeding, or renal complications) were noted.In conclusion, these methods can be safely applied during CABG, permit the realtime qualitative assessment of myocardial revascularization by the surgeon, and have the potential to quantify the physiologic significance of coronary lesions and the overall effectiveness of CABG. 69AN ANNULAR ARRAY TRANSESOPHAGEAL PROBE Annular phased array has an advantage over the linear phased array in that it is easier to implement high frequency (7.5 and 10 MHz) transducers, and it is ...
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