This monograph represents an attempt to collect the methods developed within the past decade in which echocardiography was being used to guide or to assess the results of some cardiovascular interventions or to overcome the imaging limitations of transthoracic approaches. I have entitled this book Echocardio­ graphy in Cardiac Interventions, although I am aware that this title is not entirely applicable to all the included methods. In these interventive procedures echocar­ diography preserves its noninvasive nature, and by combining it with invasive procedures, they become more accurate, safer and less invasive. The book is divided into 8 sections and 42 chapters written by many authorities in the field. When such comprehensive contributions from many authors are used, some overlapping cannot be avoided. I would like to express my appreciation to the individual contributors for their A. 1. Tajik dedication and cooperation in preparing this book. I am indebted to Dr. from the Mayo Clinic, who created a pleasant milieu for preparing the book during my sabbatical year at the Mayo Clinic. It is hoped that the reader will derive from this book a sense of where and how the ultrasound can be used in cardiovascular interventions today and what new approaches might be forthcoming. Iva Cikes List of contributors M. L. Antunes, MD., Department of Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA. J. Areeda, Cedars-Sinai Medical Center, Los Angeles, California, USA.

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1. Intracardiac Interventions.- 1.1. Intracardiac echocardiography.- 1.2. Endomyocardial biopsy of the left ventricle guided by echocardiography.- 1.3. Echocardiographic guidance of endomyocardial biopsy of the right ventricle.- 1.4. Two-dimensional echocardiographic-assisted balloon atrial septostomy.- 1.5. Color flow Doppler guiding of atrial septostomy.- 1.6. Echocardiography in transseptal cardiac catheterization.- 1.7. Percutaneous transvenous mitral commissurotomy guided and assessed by echocardiography.- 1.8. Cardiac catheterization guided by ultrasound.- 1.9. Ultrasonically marked pacing system.- 1.10. Transcatheter laser angioplasty and related techniques guided by echocardiography.- 1.11. Echocardiographic assessment of coronary venous retroperfusion.- 2. Intrapericardial Interventions.- 2.1. Pericardiocentesis guided by ultrasound.- 3. Contrast Echocardiography.- 3.1. Contrast echocardiography.- 3.2. New echocardiographic contrast agents.- 3.3. Myocardial perfusion study by contrast echocardiography.- 4. Transesophageal Echocardiography.- 4.1. Transesophageal echocardiography - technique and standard views.- 4.2. Transesophageal echocardiography - an overview of applications.- 4.3. Transesophageal echo cardiographic imaging of the thoracic aorta in aortic dissection.- 4.4. Detection of cardiac and extracardiac masses by transesophageal echocardiography.- 4.5. Diagnosis of infective endocarditis by transesophageal echocardiography.- 4.6. Detection of prosthetic valve malfunction by transesophageal echocardiography.- 4.7. Transesophageal Doppler color flow mapping: initial experience.- 5. Intraoperative Echocardiography.- 5.1. Intraoperative evaluation of valvular disease.- 5.2. Intraoperative echocardiography in valvular heart disease - quantitative study of left ventricular properties.- 5.3. Intraoperative two-dimensional echocardiography In congenital heart disease.- 5.4. Intraoperative two-dimensional echocardiography for guiding surgical correction in subvalvular aortic obstruction.- 5.5. Intraoperative assessment of left ventricular performance.- 5.6 Intraoperative contrast echocardiography can directly assess myocardial perfusion.- 5.7. Intraoperative epicardial echocardiography in recognizing acute myocardial ischemia.- 6. Doppler Echocardiography In Interventions.- 6.1. Intraoperative color flow Doppler imaging in valvular heart disease.- 6.2. Doppler for guiding and flow measurement in coronary artery surgery.- 6.3. Color flow evaluation of coronary anastomosis.- 6.4. Intraoperative Doppler color flow mapping in dissecting aneurysm of the aorta.- 6.5. Doppler monitoring of cardiac output using an implantable aortic transducer.- 6.6. Doppler echocardiography and cardiac pacing.- 6.7. Duplex scanning in arterial and venous disease.- 6.8. Doppler techniques for intraoperative arterial assessment.- 6.9. Doppler guiding of venous and arterial puncture.- 7. Stress Echocardiography.- 7.1. Exercise echocardiography.- 7.2. Stress echocardiography with transesophageal atrial pacing.- 7.3. Stress Doppler echocardiography.- 8. Cardiovascular Drug Interventions.- 8.1. Echocardiography in the assessment of cardiovascular drug interventions.- Index of Subjects.