SUMMARY The cross-sectional echocardiographic demonstration of the "goose-neck" deformity is described in four patients with endocardial cushion defect. The diagnosis was confirmed in each patient by left ventricular angiocardiogram. The subxiphoid approach of cross-sectional echocardiography in diastole allowed visualization of an elongated, narrowed, and somewhat horizontally inclined configuration of the left ventricular outflow tract, which appeared almost identical to that obtained by angiocardiography. In systole, the right border of the left ventricle was composed of the cleft anterior mitral leaflet, the left-sided line of which was convex toward the left ventricular cavity. The mitral valvular echoes were thickened, jagged and irregular, which seemed to correspond to the scalloped appearance of the right border of the left ventricular silhouette in a systolic phase of the left ventricular angiocardiogram. There were no obvious differences between the gooseneck configuration of complete-type endocardial cushion defect and that of ostium primum atrial septal defect.FROM THE DIAGNOSTIC standpoint of endocardial cushion defect (ECD), the "goose-neck" deformity as seen on the frontal projection of the left ventricular angiocardiogram is a most important feature.1-7 M-mode echocardiography has been widely used as a diagnostic tool for various cardiac malformations. The narrowing of the left ventricular outflow tract, as judged from the distance between the left side of the interventricular septum and the mitral valve on echocardiogram at the onset of systole, and the prolonged mitral-septal apposition in diastole, corresponded to the angiographic feature of the gooseneck deformity.8"-4 Recently, cross-sectional echocardiography has been used to image a more precise delineation of anatomic details of ECD.16-19 However, imaging of the goose-neck deformity in ECD by crosssectional echocardiography has not been reported. In this report we demonstrate the ability of crosssectional echocardiography to show the goose-neck deformity and compare it in detail with that obtained by angiocardiographic study. cavity, 15 normal infants, 1-3 months of age, served as controls. The patients and control subjects were examined in the supine position using the subxiphoid technique.20 The scanner probe was placed at the subxiphoid region, tilting about 20°downward from the plane of the anterior chest wall. The sector beam was positioned through the heart in a plane parallel to a line between the patient's shoulders to allow simultaneous visualization of the left ventricular cavity and the aortic root. As this subxiphoid sector view is nearly identical to the frontal projection of the left ventricular angiogram, it is suitable for evaluating the configuration of the left ventricular outflow tract of ECD. We performed this study using a real-time mechanical sector instrument (Aloka SSD 1000 with ASU 25 Hand Scanner and USM 6B Amplifier). The scanner probe, which contained a 3-MHz transducer focused at 7.5 cm, was mechanically drive...
A new noninvasive method was previously presented for the measurement of the left ventricular (LV) end-diastolic pressure (EDP) by combining Mirsky's method and the experimentally derived relationship. The eigenfrequency was determined by applying a short-time Fourier transform to the velocity signal on the human heart wall which is transcutaneously measured in vivo by the phased tracking method using ultrasound. In the Letter the authors estimate the elasticity of the heart wall for several human patients.
curately measuring the velocity signals on the multiple Absimci-We have developed a novel method for acpoints preset on an ultrasonic beam in the heart wall by tracking the movement of the heart wall. By applying the time-frequency analysis to the resultant velocity signals of the heart wall, we have determined the instantaneous eigen-frequency of the left ventricle (LV) at the end-diastole. From the eigen-frequency, the wall thickness of the LV, and the average radius of the LV, the i n n e r pressure of the LV is noninvasively estimated at the end-diastole using a model of an elastic spherical shell.the mode of the eigen-vibration in the LV. In this reFor this measurement, however, it is necessary to confirm port, therefore, we control the directions of the ultrasonic beams so that the velocity signals are simultaneously measured at the multiple points on the surface of the LV wall. From these data, we estimate the spatial distribution of the eigen-vibration of the LV wall at the end-diastole.
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