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post-interventional VSD

added by Emmel

post-interventional VSD
Comments
Posted By: Emmel (930 days ago)

Hi Pablo!! Thanks a lot for comment!

The Qp/Qs-evaluation
was just a trial to train and educate myself in haemodynamic
measurement by echocardiography. In that case I one could see the RVOT
and LVOT very well ... just training.
You´re right, the RV is
catastrophically dammaged: PAPsystolic 85 mmHg + CVP!!!
The
patient got a cardiac surgery on pump to occlude the VSD.
Retrospektive the reason for that disaster was the ablation of
ventricular extrasystoles 2 days before with accidential perforation
of inferior mid-septal myocardial wall. Perhaps the patient was quite
lucky under that cirumstances that there was no perforation of
LV-free-wall with consequential pericardial perfusion/ tamponade./>
Thanks a lot for comment and wellcome back!!!! I´m glad and
lucky to hear from you again!!
Best wishes,

Jörg.

Posted By: ohtusabes (932 days ago)

Hello my friend. Very interesting case.

Like you calculate
the Qp/Qs of 2 talk about a left to right shunt.
I note RV
function is not good...and of course, with volume overload...and if RV
function is not good...with volume overload...is logical that he can
not hemodinamically tolerate well the shunt...

Was this
case surgically resolved?

Best
Pablo


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Emmel

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Added: 04-04-2012
Runtime: 0m 32s
Views: 9000
Comments: 2

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Description

about 60 y old patient with condition after ablation of high symptomatic ventricular extrasystole in inferior mid-septale position by EPU 2 weeks ago. The patient have had dyspnoea and orthpnoea for 2 weeks: in TTE I could see the echocardiographic picture of a VSD. To evaluate and measure the Qp/ Qs-quotient via VTI in RVOT and LVOT I did a TEE. You can see the echocardiographic picture of an aneurysm in mid-septale inferior position with perforation. The haemodynamic measurement obtained following information: right-ventricular stroke-volumen about 100 ml; LV-stroke-volume about 40 ml, shunt-volume about 60 ml. Qp/ Qs > 2 We have the suspicion of a peri-/postinterventinal VSD caused by ablation in the course of EPU 2 weeks ago.


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