Real time three-dimensional echocardiography and endovascular stenting.
A 52-year-old male with HIV and chronic renal failure presented with 2-day history of fever and chills. He had recent superior vena cava (SVC) stent placement for SVC stenosis following multiple dialysis-catheter insertions. Patient's blood cultures grew methicillin-resistant staphylococcus aureus. Two-dimensional (2D) echocardiography showed no vegetations. With high clinical suspicion, 2D transesophageal echocardiogram (TEE) was obtained and confirmed no endocarditis and patent stent at SVC right atrial junction; however, entire stent was not visualized. Simultaneous three-dimensional TEE provided superior views of SVC stent in cross-sectional and longitudinal planes, clearly demonstrating patent stent without vegetations, stenosis, migration, or thrombosis.
Department of Internal Medicine-Cardiology Division, University of Texas Medical Branch, Galveston, Texas 77555-0553, USA.
Ghassan H
GH
Abusaid
Omar M
OM
Cheema
Tianrong
T
Xie
Rosario A
RA
Mercado-Young
Masood
M
Ahmad
D000328:Adult; D001807:Blood Vessel Prosthesis; D003199:Computer Systems; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D006801:Humans; D008297:Male; D011379:Prognosis; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome