CAO 106 Normal and abnormal flow by Doppler Ultrasound of the Left Internal Mammary Artery Grafted to the Left Anterior Descending Artery done by Minimal Invasive Coronary Bypass Surgery
✍ Scribed by J. Cors; C. Schulte; F. Varcla; A. Machain; E. Weinschclbaum
- Publisher
- Elsevier Science
- Year
- 1997
- Tongue
- English
- Weight
- 150 KB
- Volume
- 23
- Category
- Article
- ISSN
- 0301-5629
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✦ Synopsis
Occasionally, through the use of phonocardiography, we found high-pitched pre-systolic murmur (pre-SM), differing from Austin Flint murmur, in severe isolated AR. The aim of this study is to clarify the genesis of pre-SM in AR using echocardiography. Our subjects were 10 cases of AR with pre-SM from among a pool of 62 patients with AR. Every case showed sinus rhythm. The etiologies of AR were prolapse of aortic valve (four cases), thickening (three), and floppy valve (three). The pre-SM was recorded mostly at the cardiac apex. The characteristics of the pre-SM were similar to the pre-SM of rheumatic mitral stenosis of the high-pitched crescendo type, and continued on the first heart sound. Color Doppler echocardiography revealed massive AR jet collision with the anterior mitral leaflets which disturbed their opening motion during diastole. In conclusion, the genesis of the pre-SM in isolated severe AR might be relative mitral stenosis due to the downward direction of the AR jet and its collision with the mitral valve.