Background Doppler transthoracic echocardiography is routinely performed to measure peak mitral inflow velocities in the assessment of left ventricular diastolic function. The limitations of echocardiography are well documented, but its accuracy in the measurement of transmitral peak velocity in the presence of aortic valve regurgitation has not yet been compared with four-dimensional flow cardiac magnetic resonance imaging. Four-dimensional flow cardiac magnetic resonance imaging offers time-resolved cross-sectional velocity information that can be used to investigate mitral inflow peak velocity. We present a case report demonstrating the potential superior capabilities of four-dimensional flow cardiac magnetic resonance imaging in accurately detecting mitral inflow velocities over Doppler echocardiography in patients with aortic regurgitation. Case presentation A 67-year-old Caucasian female presented to our outpatient cardiology clinic with exertional dyspnea. Doppler transthoracic echocardiography identified moderate to severe aortic regurgitation. Mapping of mitral inflow peak velocities proved challenging with Doppler echocardiography. Additionally, four-dimensional flow cardiac magnetic resonance imaging with automated three-dimensional flow streamlines was performed, which allowed for more accurate detection of mitral inflow peak velocities. Conclusions Doppler echocardiography has a limited role in mitral inflow assessment where aortic regurgitation is present. In such cases, four-dimensional flow cardiac magnetic resonance imaging is an alternative imaging technique that may circumvent this issue and allow mitral inflow assessment.

Objective Doppler echocardiographic aortic valve peak velocity and peak pressure gradient assessment across the aortic valve (AV) is the mainstay for diagnosing aortic stenosis. Four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) is emerging as a valuable diagnostic tool for estimating the peak pressure drop across the aortic valve, but assessment remains cumbersome. We aimed to validate a novel semi-automated pipeline 4D flow CMR method of assessing peak aortic value pressure gradient (AVPG) using the commercially available software solution, CAAS MR Solutions, against invasive angiographic methods. Results We enrolled 11 patients with severe AS on echocardiography from the EurValve programme. All patients had pre-intervention doppler echocardiography, invasive cardiac catheterisation with peak pressure drop assessment across the AV and 4D flow CMR. The peak AVPG was 51.9 ± 35.2 mmHg using the invasive pressure drop method and 52.2 ± 29.2 mmHg for the 4D flow CMR method (semi-automated pipeline), with good correlation between the two methods (r = 0.70, p = 0.017). Assessment of AVPG by 4D flow CMR using the novel semi-automated pipeline method shows excellent agreement to invasive assessment when compared to doppler-based methods and advocate for its use as complementary to echocardiography.

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ABSTR9CTThis paper deals with the problem of bypass surgery.It examines the basic mechanical and physiological problems of the heart and lung. The paper assumes that the cardia-pulmonary bypass is a technique by which the pumping action of the heart and the gas exchange functions of the lung are temporarily replaced by a mechanical device,the pump oxygenator attached to the vascular system of the patient.Studies have been carried out on over 250 patients on open heart operations and clinical perfusion of cardiopulmonary bypass. The contributions of this paper is based on the results obtained from successful patients operations models of preoperative and post operative procedures.The paper revealed that patients with angina pectoris senosis complications in heart attack and young individuals with heart diseases need CPB.The result indicates that the CPB is relatively safe in the sense that many patients got releif who suffered from the intracardiac and excruciating pain.The new trend is that the study identifies bypass surgery as one of the greatest contributions,grouped in line with the disc overy of antib iotics and insolin with regards to the health care system.The method is useful in the sense that it has prevented many early deaths and has helped innumerable patients to live normal 1ives.The limitation is that only certain persons can benefit from this procedure.Computer Subroutine Models and Video recorder were used.