Adrian V. S. Lambert

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UNLABELLED Mitral regurgitation (MR) is a major determinant of outcome in cardiac surgery. The location and mechanism of mitral lesions determine the approach to various repairs and their feasibility. Because of incomplete evaluations or change in patient condition, detailed intraoperative transesophageal echocardiography (TEE) examination of the mitral(More)
PURPOSE Transesophageal echocardiography (TEE) is a useful diagnostic and monitoring tool in the operating room. In the United States, an increasing number of centres are training anesthesiologists to preform intraoperative TEE. In Canada, TEE has been slow to gain acceptance as an intraoperative monitor and little information is available on its use by the(More)
The proximal isovelocity surface area (PISA) measurement, also known as the "flow convergence" method, can be used in echocardiography to estimate the area of an orifice through which blood flows. It has many applications, but this review focuses only on its use in the intraoperative evaluation of mitral regurgitation. In that setting, PISA provides a(More)
UNLABELLED Transesophageal echocardiography (TEE) may improve intraoperative decision-making and patient outcome if it is performed and interpreted correctly. After revising our TEE examination to fulfill the published guidelines for basic TEE practitioners, we prospectively evaluated the ability of our cardiac anesthesiologists (all very experienced with(More)
BACKGROUND As aortic valve (AV) repairs become more sophisticated, surgeons need increasingly detailed information about the structure and function of this valve. Unlike two-dimensional transesophageal echocardiography (2D-TEE), using three-dimensional (3D)-TEE makes it possible to image the entire AV. We hypothesized that measuring coaptation surface area(More)
The following studies were commenced nearly three years ago, the end in view at that time being to ascertain, if possible, the effect induced on gastric function by a simple, mechanical narrowing of the pyloric orifice. In the course of numerous experiments to determine certain limits and variations of normal secretion, new questions arose, the solution of(More)
A 40-year-old man with Down syndrome presented with right heart failure. He was markedly obese and had severe developmental delay. There was marked edema and an early diastolic sound. Transthoracic echocardiography suggested a right heart mass. Transesophageal echocardiography revealed an unruptured balloon-like sinus of Valsalva aneurysm within the right(More)
Cardiac rupture represents a catastrophic complication of myocardial infarction with an exceedingly high mortality rate. In rare instances, a myocardial infarction can be complicated by 2 separate forms of rupture. The most common form of ventricular double rupture consists of free wall rupture in association with ventricular septal rupture. The present(More)