Pulmonary artery compression by a saphenous vein graft aneurysm and contrast echocardiography using an agitated mixture of ten percent air, ten percent blood, and ten percent saline

Jeon, Doo-Soo; Miyamoto, Takashi; Fontana, Gregory P.; Friedman, Arnold; Siegel, Robert J.

doi:10.1067/mje.2002.125920

Cited by 6 publications

(6 citation statements)

References 18 publications

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“…Our literature review identified 107 patients [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95]. The demographic, clinical and pathological features are summarized in ...…”

Section: Resultsmentioning

confidence: 99%

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

et al. 2005

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Aneurysmal dilatation of saphenous vein graft (SVG), first reported in 1975, is secondary to true aneurysm or pseudoaneurysm. We report 1 case and review 107 cases published since 1975. Severe SVG dilatations are large (6 ± 3 cm), occur remote from surgery (12 ± 4 years) and are life threatening, with 15.7% in-hospital mortality. Symptoms are nonspecific and the abnormality is initially observed by chest X-ray in 57% of cases. The chest X-ray abnormalities have a distinctive appearance that may suggest both diagnosis and which SVG is involved. Diagnosis is made clinically by imaging, i.e. computed tomography, echocardiography, magnetic resonance and/or surgical observation (66 cases), or most accurately by tissue evaluation by the pathologist (42 cases). Aneurysm is more common than pseudoaneurysm by a 6:1 ratio.

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Section: Resultsmentioning

confidence: 99%

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

et al. 2005

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“…Studies have shown that adding blood to AS significantly improves the performance of contrast agents ( 11 ). Jeon et al compared the characteristics of microbubbles of different contrast agents and found that the number of microbubbles was significantly more in the 10% air–10% blood-saline mixture than in the 10% air-90% saline, which resulted in higher accuracy in the measurement of pulmonary artery systolic pressure ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Agitated saline with 10% blood increases number and stability of microbubbles in detection right-to-left shunt by contrast-enhanced transcranial Doppler: an in vitro and in vivo observational study

Li¹,

Shen²,

Deng³

et al. 2023

J Thorac Dis

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Background Agitated saline (AS) with blood has been shown to have good tolerance and increased efficacy when used in contrast-enhanced transcranial Doppler (c-TCD) to detect right-to-left shunt (RLS). However, little is known about the effects of blood volume on c-TCD results. Our study investigated the characterization of AS with different blood volumes in vitro and compared the c-TCD results in vivo . Methods In vitro , AS without blood, AS with 5% blood (5% BAS), and AS with 10% blood (10% BAS) were prepared based on previous studies and observed under microscopy. The numbers and sizes of the microbubbles from different contrast agents were compared immediately, 5 min, and 10 min post-agitation. In vivo , 74 patients were recruited. c-TCD was repeated 3 times using AS with different blood volumes in each patient. Signal detection times, positive rates, and classifications of RLS were compared among the 3 groups. Results In vitro , the AS without blood produced 5.4±2.4/field microbubbles after agitation, the 5% BAS produced 30.4±4.2/field, and the 10% BAS produced 43.9±12.7/field. More microbubbles remained in the 10% BAS than the 5% BAS within 10 min (18.5±6.1 vs. 7.1±2.0/field, P<0.001). The size of the microbubbles from the 5% BAS increased from 9.2±8.2 to 22.1±10.6 µm within 10 min post-agitation (P=0.014), while the 10% BAS changed insignificantly. In vivo , the signal detection times of the 5% BAS (1.1±0.7 s) and 10% BAS (1.0±0.8 s) were significantly shorter than the AS without blood (4.0±1.5 s, P<0.0001). The RLS positive rates were 63.5%, 67.6% and 71.6% in AS without blood, 5% BAS and 10% BAS respectively; however, the differences were not statistically significant. The AS without blood reached 12.2% level III RLS, while the 5% BAS reached 25.7%, and the 10% BAS reached 35.1% (P=0.005). Conclusions The 10% BAS would be suggested in c-TCD as it addressed larger RLS by increasing the number and stability of microbubbles, and it improves the diagnosis of patent foramen ovale (PFO).

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“…There is particular concern for the possibility of myocardial infarction from coronary air embolization. 1 , 2 , 5 …”

Section: Discussionmentioning

confidence: 99%

“…Saline contrast echocardiography is therefore considered confirmatory for a right-to-left shunt when microbubbles are detected in the left side of the heart following intravenous injection. 1 , 2 , 3 , 4 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

Myocardial Enhancement Following Agitated Saline Contrast Study in a Boxer Dog

Moy-Trigilio

Keene

Barker

et al. 2023

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Pulmonary artery compression by a saphenous vein graft aneurysm and contrast echocardiography using an agitated mixture of ten percent air, ten percent blood, and ten percent saline

Cited by 6 publications

References 18 publications

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

Agitated saline with 10% blood increases number and stability of microbubbles in detection right-to-left shunt by contrast-enhanced transcranial Doppler: an in vitro and in vivo observational study

Myocardial Enhancement Following Agitated Saline Contrast Study in a Boxer Dog

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