A 75-year-old male with persistent atrial fibrillation underwent implantation of a left atrial occlusion device. After 6 weeks, a scheduled trans-esophageal echocardiogram showed a 1.1-cm × 1.1-cm mass within the occluded left atrial appendage, suspected to be thrombus. He was continued on warfarin for an additional 6 weeks and a repeat trans-esophageal echocardiogram showed obliteration of the left atrial appendage. This report describes an uncommon observation detected at scheduled follow up by trans-esophageal echocardiogram, which sheds some light on the mechanism by which this device “matures” after it is implanted inside the left atrial appendage.

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Endophthalmitis as a first manifestation of right-sided endocarditis in a patient with patent foramen ovale

Rodrigues, Ana; Ogawa, Andrea; Mota, Juliana; Carbone, Aime; Arruda, Ana; Furtado, Meive; Pinheiro, Jairo; Andrade, José

2012 Journal of Echocardiography

doi: 10.1007/s12574-012-0116-2pmid: 27278047

Endogenous endophthalmitis is a rare complication of endocarditis, rendering poor visual prognosis. We report a case of a 66-year-old female with renal failure who presented with fever, ocular pain, and purulent eye discharge. After a diagnosis of endogenous endophthalmitis, she was treated with antibiotics and enucleation of the eye. Due to persistent fever and positive blood cultures, a transesophageal echocardiography was undertaken, disclosing a large mural vegetation in the right atrium, catheter-associated vegetations, and a patent foramen ovale. Endocarditis is an uncommon source of endogenous endophthalmitis, and has rarely been associated to right-sided endocarditis and paradoxical septic embolization.

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A case of significantly increased mitral regurgitation early after atrial septal defect closure

Nishiga, Masataka; Izumi, Chisato; Matsutani, Hayato; Hashiwada, Sumiyo; Takahashi, Shuichi; Hayama, Yukiko; Nakajima, Seiko; Sakamoto, Jiro; Hanazawa, Koji; Miyake, Makoto; Tamura, Toshihiro; Kondo, Hirokazu; Motooka, Makoto; Kaitani, Kazuaki; Nakagawa, Yoshihisa

2012 Journal of Echocardiography

doi: 10.1007/s12574-012-0123-3pmid: 27278048

We report a rare case in which mitral regurgitation (MR) was exacerbated to a severe level early after atrial septal defect (ASD) closure, even though the female patient had preoperatively mild MR and mild changes in mitral valve (MV) and sinus rhythm. The mechanism of increased MR was considered as poor coaptation and tethering of the MV due to the restricted motion of the posterior leaflet in addition to geometric changes of the left ventricle (LV) after ASD closure.

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Left main coronary artery origin from the right coronary sinus: rare, dangerous, and easy to miss on routine transoesophageal echocardiography

Robaei, Daniel; Nayyar, Dhruv; Buchholz, Stefan

2012 Journal of Echocardiography

doi: 10.1007/s12574-012-0113-5pmid: 27278049

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Left ventricular undulation in a patient with atrial flutter

Misumi, Ikuo; Fujimoto, Akiko; Ishizaki, Masatoshi; Masuda, Teruaki; Nishida, Yasuto; Tateishi, Machiko; Tawara, Akie; Ueyama, Hidetsugu; Imamura, Shigehiro; Matsumoto, Mitsuhiro; Sugiyama, Seigo; Ogawa, Hisao

2012 Journal of Echocardiography

doi: 10.1007/s12574-012-0114-4pmid: 27278050