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A 37‐year‐old man with prosthetic aortic valve and composite aortic graft was admitted to our emergency department with syncope and dyspnea. A transesophageal echocardiography revealed a vegetative mass on the aortic mechanic valve and a flow that originates from the left ventricle into the periaortic echogenic free space. There were a partial dehiscence of the mechanical valve conduit from the base of the heart and a periaortic root abscess/hematoma. Real time three‐dimensional TEE revealed complete disarticulation of the aortic graft that was totally collapsing during systole. We herein report a case who presented with syncope secondary to entire aortic graft collapse and periaortic annular abscess. [ABSTRACT FROM AUTHOR]

Aim Atrial septal defect ( ASD) causes chronic volume overload of the right heart. The potential adverse effects of this long-standing volume overload to left atrium ( LA) and left ventricle ( LV) and their response to ASD closure has been poorly studied. Methods We studied 20 ASD patients before the procedure, at the 24-hour and 1 month following the percutaneous closure. Twenty age-matched controls served as the control group. The analysis for atrial deformation was performed on the lateral wall, mid segment of the LA from apical four-chamber view. Peak longitudinal strain (S) and strain rate ( SR) during LA reservoir, passive emptying, atrial contraction phases and LV global longitudinal systolic S and SR were measured. Results Peak S and SR at LA reservoir, conduit and late contraction phases in ASD patients were similar to controls. All of these parameters increased immediately after the closure of the defect. Similarly, SLV and SRLV in ASD patients were not significantly different from the controls and significantly increased after the closure. But LA S, SR and LV S, SR results decreased in 1 month after the closure. SLV in ASD patients was significantly correlated with echocardiographic findings and the invasively measured defect size. Conclusion LA and LV S and SR are not significantly affected in ASD patients. However, correction of the long-standing volume overload by percutaneous closure causes an early increase in LA and LV longitudinal deformation that correlates with the magnitude of the atrial septal defect. But this increase decreased in 1 month after closure. [ABSTRACT FROM AUTHOR]

Background: Quantitative assessment of the right ventricular ( RV) function in atrial septal defect ( ASD) patients before and after closure remains difficult. The aim of this study was to assess the regional RV function in ASD patients, to evaluate the extent and time course of RV remodeling following ASD closure, and to investigate whether any regional difference exists in RV remodeling. Methods: Twenty patients with ASD and 20 age-matched controls were included. All underwent standard echocardiography and two-dimensional strain ( S) and strain rate ( SR) imaging by speckle tracking before, and 24 hours and 1 month after the defect closure. Results: Right ventricular S was higher in ASD patients except apical lateral segment S, which was lower when compared with controls. There was no difference in RV SR between ASD patients and controls. RV septal S and SR, and lateral SR decreased in 24 hours after the procedure and remained the same at 1 month. RV lateral basal and mid S decreased and apical S increased in 24 hours after the closure. All 3 segments showed some more increase at 1 month. RV apical S showed strong correlations with systolic pulmonary artery pressure and global RV systolic function indices. Conclusions: Chronic volume overload in ASD patients causes alterations in RV deformation. Percutaneous closure results in rapid remodeling and normalization of RV deformation. The major geometrical and deformational changes are completed in 24 hours. Lateral wall S seems to reflect the RV deformational changes due to volume loading and unloading better than SR in ASD patients. [ABSTRACT FROM AUTHOR]

Background: Although carotid stenting is an effective treatment for severe carotid stenosis, it has been associated with alterations in autonomic functions (which may influence diastolic parameters) during or shortly after the procedure. Aim: To determine whether there is any relation between the alteration in autonomic functions and diastolic functions by transthoracic echocardiography (TTE). Material and methods: Patients (15 male, 7 female) who were suitable for carotid artery stenting, without a history of hypertension, diabetes mellitus, or severe coronary artery or valvular heart disease, were enrolled in our study. Transthoracic echocardiography recordings were obtained before, and the day after the procedure. E wave velocity, A wave velocity, E/A ratio, mitral E wave deceleration time (DT), isovolumic relaxation time (IVRT), and by using tissue Doppler echocardiography Ea, Aa, Ea/Aa and E/Ea ratios were measured. Results were statistically analysed using Friedman and Wilcoxon tests. Results: While E wave velocity, and E/A ratio increased non-significantly (78 ±20, 0.88 ±0.17/82 ±20, 0.96 ±0.22), A wave and Aa velocities did not change after the procedure (87 ±18, 8.5 ±1.6/88 ±21, 8.6 ±1.5). The value of Ea increased significantly (9 ±1.7/9.9 ±2) and the E/Ea ratio decreased non-significantly after the procedure (8.6 ±1.1/7.8 ±1.9). Values of IVRT and DT decreased significantly after the procedure (91 ±16, 220 ±44/86 ±18, 200 ±23). Conclusions: Sympathetic overactivity may impair diastolic functions. By carotid artery stenting, which is associated with an increase in parasympathetic activity by a vagally mediated stimulus, diastolic functions may improve. In our study, echocardiographic parameters showed improvement in diastolic functions. [ABSTRACT FROM AUTHOR]