Edward S Katz, M.D.

A Case of an Anomalous Superior Vena Cava with Anomalous Pulmonary Veins-When Two Wrongs Do not Make a Right
Hong, Susie N; Nayar, Ambika; Srichai, Monvadi B; Morgan, Jeffrey A; Meyer, David; Katz, Edward
2011 Feb;28(2):E39-E41, Echocardiography
Intravenous agitated saline injection is useful in identifying right-to-left shunting at the atrial or intrapulmonary level. Anomalous systemic venous drainage to the left atrium is a rare but easily correctable cause of right-to-left shunting which, if left undiagnosed, may have serious consequences, including meningitis and pyogenic brain abscesses. This case illustrates an unusual cause of right-to-left shunting and the utility of venous microbubble injection in its diagnosis. (Echocardiography 2011;28:E39-E41)
— id: 122531, year: 2011, vol: 28, page: E39, stat: Journal Article,

The 'A-dip' of diastolic mitral regurgitation: an unusual Doppler flow pattern in a patient with severe aortic insufficiency and complete heart block
Berger, Rachel Levine; Katz, Edward; Tunick, Paul; Kronzon, Itzhak
2008 Jan;9(1):69-71, European journal of echocardiography
This is an unusual case of diastolic mitral regurgitation (MR) with a high diastolic velocity jet and prolonged jet duration related to a combination of acute severe aortic insufficiency and high-degree atrioventricular block. This case illustrates an interesting hemodynamic phenomenon with multiple transient decreases in the pressure gradient between the left ventricle and left atrium during diastole related to a temporary increase in left atrial pressure associated with atrial contraction
— id: 79134, year: 2008, vol: 9, page: 69, stat: Journal Article,

Cardiac arrest following anaesthetic induction in a world-class bodybuilder
Angelilli, Allison; Katz, Edward S; Goldenberg, Ronald M
2005 Aug;60(4):443-444, Acta cardiologica
This is a report of a 41-year-old professional male bodybuilder with a history of active anabolic-androgenic steroid abuse and a normal echocardiogram two years prior to admission who experienced a near-fatal arrhythmia during anaesthetic induction for elective orthopaedic surgery. The patient had severe concentric left ventricular hypertrophy, diffuse left ventricular hypokinesis, decreased ejection fraction and inducible monomorphic ventricular tachycardia. A single-chamber cardioverter/defibrillator was inserted
— id: 67869, year: 2005, vol: 60, page: 443, stat: Journal Article,

Isolated subclavian artery aneurysm: evaluation by transesophageal echocardiography
Shah, Alan; Katz, Edward S; Stern, Alexandra; Tunick, Paul A; Kronzon, Itzhak
2004 Jan;21(1):73-76, Echocardiography
A 50-year-old man was evaluated following a motor vehicle accident. Chest X-ray showed a widened mediastinum. Transesophageal echocardiography was helpful in identifying the left subclavian artery and in demonstrating an isolated subclavian artery aneurysm. The TEE findings correlated well with the results of chest CT. Using TEE for the identification of the aortic branches in patients with chest trauma may be critical
— id: 43006, year: 2004, vol: 21, page: 73, stat: Journal Article,

Doppler diagnosis of acute occlusion of the superior vena cava
Benenstein, Ricardo; Nayar, Ambika C; Rosen, Robert; Schlossberg, Peter; Katz, Edward S; Tunick, Paul A; Kronzon, Itzhak
2003 Jan;20(1):97-98, Echocardiography
— id: 39153, year: 2003, vol: 20, page: 97, stat: Journal Article,

Bilateral pulmonary artery compression and obstruction by tumor: diagnosis by unusual Doppler flow patterns
Katz, Edward S; Shah, Alan; Rosenzweig, Barry P; Tunick, Paul A; Kronzon, Itzhak
2003 Feb;16(2):185-187, Journal of the American Society of Echocardiography
Pulmonary artery obstruction may be caused by tumor within or external to the arteries. Presented here is a patient with life-threatening compromise in pulmonary flow that was caused by a pulmonary neoplasm. The Doppler echocardiogram showed subtotal narrowing of the right pulmonary artery and total occlusion of the left pulmonary artery. In addition, the beneficial effects of chemotherapy were documented by Doppler
— id: 36576, year: 2003, vol: 16, page: 185, stat: Journal Article,

Echocardiography in the identification of unusual surgical errors resulting from attempted closure of secundum atrial septal defects: Report of two cases
Kronzon, Itzhak; Tunick, Paul A; Rosenzweig, Barry P; Katz, Edward S; Colvin, Stephen B
2003 Jul;16(7):774-776, Journal of the American Society of Echocardiography
— id: 36723, year: 2003, vol: 16, page: 774, stat: Journal Article,

Cloning the clinician: A method for assessing illusory mental health
Shedler, J; Karliner, R; Katz, E
2003 JUN ;59(6):635-650, Journal of clinical psychology
Self-report mental health scales cannot distinguish between genuine mental health and the facade or illusion of mental health created by psychological defenses. Shedler, Mayman, and Manis (1994) demonstrated that experienced clinicians can differentiate genuine from illusory mental health using the Early Memory Test, and that illusory mental health may be a risk factor for medical illness. This article describes the development of the Early Memory Index (EMI), a formal scoring system for the Early Memory Test, and presents evidence for its reliability and validity. The EMI makes the technique for assessing illusory mental health accessible to a wide range of investigators, including investigators who lack extensive clinical training. (C) 2003 Wiley Periodicals, Inc
— id: 37138, year: 2003, vol: 59, page: 635, stat: Journal Article,

The risk of the development of aortic stenosis in patients with "benign" aortic valve thickening
Cosmi, John E; Kort, Smadar; Tunick, Paul A; Rosenzweig, Barry P; Freedberg, Robin S; Katz, Edward S; Applebaum, Robert M; Kronzon, Itzhak
2002 Nov 11;162(20):2345-2347, Archives of internal medicine
BACKGROUND: Aortic valve thickening (AVT) without aortic stenosis (AS) is common and was often considered benign. However, it has recently been found to be associated with increased morbidity and mortality. It is unknown whether patients with AVT are at risk for the development of AS. METHODS: Our echocardiography database from 1987 to 1993 was searched for cases of AVT with at least 1 year of echocardiographic follow-up. The risk of the development of AS was compared in patients with and without AVT. RESULTS: There were 2131 patients with AVT and at least 1 year of echocardiographic follow-up. Aortic stenosis developed in 338 patients (15.9%) (mild, 10.5%; moderate, 2.9%; and severe, 2.5%). Multivariate analysis, including age, left ventricular hypertrophy, and mitral annular calcification, revealed that only mitral annular calcification was independently and significantly associated with progression to AS. CONCLUSIONS: Aortic valve thickening without stenosis is common, and it may progress to significant AS. It is possible that this development of AS may be responsible for some of the increased morbidity and mortality in patients with AVT
— id: 39568, year: 2002, vol: 162, page: 2345, stat: Journal Article,

Effect of treatment on the incidence of stroke and other emboli in 519 patients with severe thoracic aortic plaque
Tunick, Paul A; Nayar, Ambika C; Goodkin, Gregory M; Mirchandani, Sunil; Francescone, Steven; Rosenzweig, Barry P; Freedberg, Robin S; Katz, Edward S; Applebaum, Robert M; Kronzon, Itzhak
2002 Dec 15;90(12):1320-1325, American journal of cardiology
Severe aortic plaques seen on transesophageal echocardiography (TEE) are a high-risk cause of stroke and peripheral embolization. Evidence to guide therapy is lacking. Retrospective information was obtained regarding the occurrence of embolic events (stroke, transient ischemic attacks, or peripheral emboli) in 519 patients with severe thoracic aortic plaque seen on TEE since 1988. Treatment with statins, warfarin, or antiplatelet medications was noted. Treatment was not randomized. In a matched-paired analysis, each patient taking each class of therapy was matched for age, gender, previous embolic event, hypertension, diabetes, congestive failure, and atrial fibrillation to someone not taking that medication. Multivariate analysis was also performed. An embolic event occurred in 111 patients (21%). Multivariate analysis showed that statin use was independently protective against recurrent events (p = 0.0001). Matched analysis also showed a protective effect of statins (p = 0.0004; absolute risk reduction 17%, relative risk reduction 59%, number needed to treat [n = 6]). No protective effect was found for warfarin or antiplatelet drugs. The odds ratio for embolic events was 0.3 (95% confidence interval [CI] 0.2 to 0.6) for statin therapy, 0.7 (95% CI 0.4 to 1.2) for warfarin, and 1.4 (95% CI 0.8 to 2.4) for antiplatelet agents. Thus, there is a protective effect of statin therapy, and no significant benefit of warfarin or antiplatelet drugs on the incidence of stroke and other embolic events in patients with severe thoracic aortic plaque on TEE
— id: 36577, year: 2002, vol: 90, page: 1320, stat: Journal Article,

Unusual echocardiographic views of bicuspid and tricuspid pulmonic valves
McAleer E; Kort S; Rosenzweig BP; Katz ES; Tunick PA; Phoon CK; Kronzon I
2001 Oct;14(10):1036-1038, Journal of the American Society of Echocardiography
The pulmonary artery is typically seen on transthoracic echocardiography in its longitudinal axis. Therefore, short axis views of the pulmonic valve leaflets are not generally obtained, and the distinction between tricuspid and bicuspid pulmonic valves is difficult or impossible. Bicuspid pulmonic valve is one cause of pulmonic stenosis, which is especially common in tetralogy of Fallot. Presented here are 2 patients in whom the orientation of the pulmonary artery was unusual, and the pulmonic valve was seen en face. The first patient had tetralogy of Fallot and a bicuspid pulmonic valve. The severe obstruction to right ventricular outflow was infundibular. The second patient had severe stenosis of a tricuspid pulmonic valve, which was treated with balloon valvuloplasty. These unusual views of the pulmonic valve leaflets were obtained because of anterior displacement of the pulmonary artery, and precise anatomic delineation of the problem in each case was possible with transthoracic echocardiography
— id: 26604, year: 2001, vol: 14, page: 1036, stat: Journal Article,

Abdominal aortic aneurysms and thoracic aortic atheromas
Reynolds HR; Tunick PA; Kort S; Rosenzweig BP; Freedberg RS; Katz ES; Applebaum RM; Portnay EL; Adelman MA; Attubato MJ; Kronzon I
2001 Nov;14(11):1127-1131, Journal of the American Society of Echocardiography
BACKGROUND: Abdominal aortic aneurysm (AAA) is associated with atherosclerosis elsewhere. Thoracic aortic atheromas (ATHs) seen on transesophageal echocardiography (TEE) are an important cause of stroke and peripheral embolization. The purposes of this study were to determine whether an association exists between AAA and ATHs and to assess the importance of screening patients with ATHs for AAA. METHODS: For the retrospective analysis, 109 patients with AAA and 109 matched controls were compared for the prevalence of ATHs on TEE and for historical variables. For the prospective analysis, screening for AAA on ultrasonography was performed in 364 patients at the time of TEE. RESULTS: Results of the retrospective analysis showed that ATHs were present in 52% of patients with AAA and in 25% of controls (odds ratio [OR] = 3.3; P =.00003). There was a significantly higher prevalence of hypertension, myocardial infarction, heart failure, smoking, and carotid or peripheral arterial disease in patients with AAA. However, only ATHs were independently associated with AAA on multivariate analysis (P =.001). Results of the prospective analysis showed that screening at the time of TEE in 364 patients revealed AAA in 13.9% of those with ATHs and in 1.4% of those without ATHs (P <.0001; OR = 11.4). CONCLUSIONS: (1) There is a strong, highly significant association between abdominal aneurysm and thoracic atheromas. (2) Patients with AAA may be at high risk for stroke because of the concomitance of thoracic aortic atheromas. (3) The high prevalence of abdominal aneurysm in patients with thoracic atheromas suggests that screening for abdominal aneurysm should be carried out in all patients with thoracic atheromas identified by TEE
— id: 26574, year: 2001, vol: 14, page: 1127, stat: Journal Article,

Thromboembolus from a ligated left atrial appendage
Rosenzweig BP; Katz E; Kort S; Schloss M; Kronzon I
2001 May;14(5):396-398, Journal of the American Society of Echocardiography
The left atrial appendage of patients with mitral valve disease is commonly a source of thromboembolus and is often ligated during mitral valve surgery to diminish this risk. However, ligation is often incomplete. We describe a patient with a stroke whose only source of embolus was an incompletely ligated left atrial appendage. Attempts to exclude the left atrial appendage from the arterial circulation by suture ligation may not decrease the risk of thromboemboli and instead may increase such risk
— id: 20686, year: 2001, vol: 14, page: 396, stat: Journal Article,

Pulmonary venous flow in large, uncomplicated atrial septal defect
Saric M; Applebaum RM; Phoon CK; Katz ES; Goldstein SA; Tunick PA; Kronzon I
2001 May;14(5):386-390, Journal of the American Society of Echocardiography
BACKGROUND: The pulmonary venous flow velocity pattern (PVFVP) in atrial septal defect (ASD) has not been previously studied in detail. Normally, PVFVP is primarily determined by the left heart performance. We hypothesized that the impact of left-sided heart dynamics on PVFVP is diminished in patients with ASD because of the presence of a left-to-right shunt into the low-resistance right side of the heart. METHODS AND RESULTS: Transesophageal echocardiography was performed in 19 adults and 3 children with a large, uncomplicated secundum ASD (maximum diameter 0.6 to 3.0 cm). All patients were in normal sinus rhythm with an average heart rate of 78 bpm in adults and 116 bpm in children. In 21 subjects the antegrade PVFVP lacked distinct systolic (S) and diastolic (D) waves. Instead, we observed a single continuous antegrade wave extending from the beginning of systole to the onset of atrial contraction. Furthermore, the amplitude of the atrial reversal (AR) wave was smaller than in historical controls. In 3 patients in whom ASD was surgically repaired, we observed an immediate return of distinct S and D waves postoperatively. This confirmed that PVFVP abnormality was indeed the result of the ASD. Also a large increase in the AR wave amplitude (46 + 15 cm/s) was noted postoperatively. CONCLUSIONS: This previously unrecognized PVFVP comprising a single continuous antegrade wave and a diminished AR wave sheds new light on the hemodynamics of ASDs. Its presence may also alert the echocardiographer to the possibility of an ASD when the septal defect cannot be visualized directly
— id: 20687, year: 2001, vol: 14, page: 386, stat: Journal Article,

Surgical left atrial appendage ligation is frequently incomplete: A transesophageal echocardiographic study
Katz ES; Tsiamtsiouris T; Applebaum RM; Schwartzbard A; Kronzon I
2000 Aug;36(2):468-471, Journal of the American College of Cardiology
OBJECTIVES: This study sought to determine the incidence of incomplete ligation of the left atrial appendage (LAA) during mitral valve surgery. BACKGROUND: Ligation of the LAA to prevent future thromboembolic events is commonly performed during mitral surgery. However, success in completely exduding the appendage from the circulation has never been systematically assessed. METHODS: Using transesophageal Doppler echocardiography, we studied 50 patients who underwent mitral valve surgery and ligation of the LAA. Thirty patients were studied immediately postoperative, and 20 patients were studied 6 days to 13 years after surgery. Incomplete ligation was detected by demonstrating a color jet traversing the separation between the left atrial body and appendage. RESULTS: Transesophageal echocardiography detected incomplete LAA ligation in 18 of 50 (36%) patients. The incidence of incomplete ligation was not significantly different between patients studied immediately postoperative and patients studied at various times after surgery. Type of mitral surgery (repair vs. replacement), operative approach (sternotomy vs. port access), left atrial size or degree of mitral regurgias unrelated to type of surgery, surgical approach, left atrial size or degree of mitral regurgitation. Residual communication between the incompletely ligated appendage and the left atrial body may produce a milieu of stagnant blood flow within the appendage and be a potential mechanism for embolic events
— id: 8152, year: 2000, vol: 36, page: 468, stat: Journal Article,

Aortic valve replacement in patients with aortic stenosis and severe left ventricular dysfunction
Powell DE; Tunick PA; Rosenzweig BP; Freedberg RS; Katz ES; Applebaum RM; Perez JL; Kronzon I
2000 May 8;160(9):1337-1341, Archives of internal medicine
BACKGROUND: The outcome of aortic valve replacement for severe aortic stenosis is worse in patients with impaired left ventricular function. Such dysfunction in aortic stenosis may be reversible if caused by afterload mismatch, but not if it is caused by superimposed myocardial infarction. METHODS: From our echocardiography database, 55 patients with severe aortic stenosis (valve area < or =0.75 cm2) and ejection fractions of 30% or lower who subsequently underwent aortic valve replacement were included. The operative mortality and clinical follow-up were detailed. RESULTS: There were 10 perioperative deaths (operative mortality, 18%). Twenty (36%) of the 55 patients had a prior myocardial infarction. In the 35 patients without prior myocardial infarction, there was only 1 death (3%). In contrast, 9 of 20 patients with prior myocardial infarction died (mortality rate, 45%; P< or =.001). The factors significantly associated with perioperative death on univariate analysis (functional class, mean aortic gradient, and prior myocardial infarction) were entered into a model for stepwise logistic regression. This multivariate analysis showed that only prior myocardial infarction was independently associated with perioperative death (odds ratio, 14.9; 95% confidence interval, 2.4-92.1; P = .004). CONCLUSIONS: The risk of aortic valve replacement in patients with severe aortic stenosis and severely reduced left ventricular systolic function is extremely high if the patients have had a prior myocardial infarction. This information should be factored into the risk-benefit analysis that is done preoperatively for these patients, and it may preclude operation for some
— id: 11701, year: 2000, vol: 160, page: 1337, stat: Journal Article,

Diagnosis of a giant coronary aneurysm with multiple imaging modalities
Strouse D; Katz ES; Tunick PA; Winer HE; Krinsky GA; Galloway AC; Kronzon I
2000 Feb;17(2):173-176, Echocardiography
Echocardiography demonstrated an 8-cm mass adjacent to the right side of the heart in a 79-year-old man with a history of hypertension and a repaired abdominal aortic aneurysm. The results of Doppler echocardiography and magnetic resonance imaging suggested the diagnosis of an unusually large coronary artery aneurysm, and this was confirmed with coronary angiography. At surgery, the 8- to 10-cm coronary aneurysm was resected, and the patient made an uneventful recovery
— id: 27877, year: 2000, vol: 17, page: 173, stat: Journal Article,

Effects of intraaortic balloon counterpulsation on carotid artery blood flow
Applebaum RM; Wun HH; Katz ES; Tunick PA; Kronzon I
1998 May;135(5 Pt 1):850-854, American heart journal
BACKGROUND: The intraaortic balloon pump has been shown to improve cardiac output and diastolic coronary flow. Animal studies with balloon counterpulsation have shown variable effects on carotid and cerebral blood flow. We investigated the effects of counterpulsation with the intraaortic balloon pump on blood flow in the common carotid artery in human beings. METHODS AND RESULTS: We studied 14 patients who had an intraaortic balloon pump placed for clinical indications; 9 were hypotensive (4 in the setting of an acute myocardial infarction and 5 immediately after cardiac surgery). Five patients required counterpulsation after undergoing complicated coronary angioplasty. Common carotid artery blood flow was assessed with carotid Duplex scanning both with and without 1:1 balloon augmentation. We found no net increase in the total blood flow in the common carotid artery with intraaortic balloon counterpulsation. This result occurred despite a significant mean increase in both the peak flow velocity and flow velocity integral of the augmented diastolic flows by 160% and 78%, respectively. Total flow did not change because an early systolic reversal of blood flow was seen only with balloon augmentation, which negated the augmented diastolic flow. CONCLUSION: Despite a significant augmentation in diastolic blood flow with balloon counterpulsation, no increase occurred in total carotid artery blood flow. This appeared to be caused by improper timing of balloon deflation. This could result in no improvement in cerebral blood flow with intraaortic balloon pump counterpulsation in critically ill patients
— id: 7485, year: 1998, vol: 135, page: 850, stat: Journal Article,

Surgical left atrial appendage ligation is frequently incomplete: A transesophageal echocardiographic study
Katz, ES; Tsiamtsiouris, T; Applebaum, RM; Schwartzbard, A; Kronzon, I
1998 OCT 27 ;98(17):501-501, Circulation
— id: 53667, year: 1998, vol: 98, page: 501, stat: Journal Article,

Sequential external counterpulsation increases cerebral and renal blood flow
Applebaum RM; Kasliwal R; Tunick PA; Konecky N; Katz ES; Trehan N; Kronzon I
1997 Jun;133(6):611-615, American heart journal
The purpose of this study was to evaluate the effect of sequential external counterpulsation (SECP) on cerebral and renal blood flow. The effect of SECP on carotid and renal artery blood flow was studied in 35 and 18 patients, respectively. With a portable unit, cuffs were applied to the calves and thighs, sequentially inflated with air at the onset of diastole, and deflated at the onset of systole. Carotid and renal artery Duplex studies were performed during intermittent SECP. Flow velocity and flow velocity integral were measured at baseline and during SECP. Diastolic augmentation of carotid and renal artery flow velocity was observed in all patients. The mean carotid flow velocity integral increased by 22% from 27.7 +/- 1.8 cm to 33.1 +/- 2.3 cm (P = 0.001). The mean renal artery flow velocity integral increased by 19% from 21 +/- 1 cm to 25 +/- 1 cm (P = 0.0001). With SECP, a new diastolic Doppler flow velocity wave was observed, with an average peak carotid diastolic flow velocity of 56 +/- 4 cm/sec and an average peak renal artery diastolic flow velocity of 40 +/- 2.5 cm/sec. This diastolic wave was 75% (carotid) and 68% (renal) as high as the systolic wave during SECP. In addition, with SECP the systolic wave increased by 6% and 8% in the carotid and renal artery, respectively (P = 0.02 and 0.006, respectively). In conclusion, SECP significantly increases carotid and renal blood flow. This noninvasive, harmless treatment may be useful to support patients with decreased cerebral and renal perfusion
— id: 7103, year: 1997, vol: 133, page: 611, stat: Journal Article,

Intra-aortic balloon pumping does not improve carotid artery blood flow
Applebaum, RM; Wun, HH; Katz, ES; Tunick, PA; Kronzon, I
1997 FEB ;29(2):8043-8043, Journal of the American College of Cardiology
— id: 53291, year: 1997, vol: 29, page: 8043, stat: Journal Article,

Increase in renal blood flow with external counterpulsation
Kasliwal, R; Trehan, N; Tunick, PA; Konecky, N; Applebaum, RM; Katz, ES; Kronzon, I
1997 FEB ;29(2):14157-14157, Journal of the American College of Cardiology
— id: 53290, year: 1997, vol: 29, page: 14157, stat: Journal Article,

Tortuosity of the descending thoracic aorta simulating dissection on transesophageal echocardiography
Katz ES; Applebaum RM; Earls JP; Krinsky G; Weinreb J; Kronzon I
1997 Jan-Feb;10(1):83-87, Journal of the American Society of Echocardiography
In an 80-year-old patient with syncope, a markedly tortuous descending thoracic aorta produced images on transesophageal echocardiography which were suggestive of an intimal flap caused by dissection. A magnetic resonance aortogram clearly showed that the trans-esophageal echocardiogram was a false positive. In addition, multiplanar reconstructed images of the magnetic resonance aortogram through the tortuous descending thoracic aorta could reproduce images similar to that seen by transesophageal echocardiography. Because transesophageal echocardiography has become a popular imaging modality for the detection of aortic dissection, it is essential for echocardiographers to be aware of possible pitfalls which may create false positive findings
— id: 12417, year: 1997, vol: 10, page: 83, stat: Journal Article,

Correlation between plasma homocyst(e)ine and aortic atherosclerosis
Konecky N; Malinow MR; Tunick PA; Freedberg RS; Rosenzweig BP; Katz ES; Hess DL; Upson B; Leung B; Perez J; Kronzon I
1997 May;133(5):534-540, American heart journal
Plasma homocyst(e)ine [H(e)] levels correlate with the prevalence of arterial occlusive diseases. Recently, transesophageal echocardiography (TEE) has been used to evaluate patients with atherosclerotic plaques in the thoracic aorta. The purpose of this study was to determine whether H(e) levels correlate with the degree of atherosclerotic plaque in the thoracic aorta (ATH) as seen on TEE. Maximum plaque areas for three locations in the thoracic aorta (arch, proximal descending, and distal descending) were measured with TEE in 156 patients. Maximum plaque areas for these locations were added to yield an estimate of ATH. ATH and H(e) levels, and levels of folic acid, vitamin B12, and pyridoxal 5'-phosphate were measured in a double-blind manner. Univariate analysis demonstrated a significant correlation of H(e) with ATH (r = 0.3, p< 0.001). On multivariate analysis, H(e) was independently predictive of ATH (r for the model including H(e) was 0.63, p < 0.0001). Plasma H(e) levels are therefore significantly and independently correlated with the degree of atherosclerosis in the thoracic aorta
— id: 12323, year: 1997, vol: 133, page: 534, stat: Journal Article,

Incomplete occlusion of left ventricular aneurysms after endoventricular aneurysmorrhaphy: diagnosis by echocardiography and ventriculography
Katz ES; Applebaum RM; Pierson C; Chinitz L; Colvin SB; Kronzon I
1996 May;38(1):96-99, Catheterization & cardiovascular diagnosis
Surgical treatment of left ventricular aneurysms have recently focused on maintaining normal left ventricular geometry by using a circular patch repair to exclude the aneurysmal cavity (endoaneurysmorrhaphy). We describe two patients who underwent this procedure and were subsequently found by echocardiography and angiography to have a residual communication between the left ventricular cavity and the aneurysm which contained thrombus. This finding may have implications regarding the optimal hemodynamic result of the surgery and the risk of thromboembolism
— id: 12616, year: 1996, vol: 38, page: 96, stat: Journal Article,

Visualization and identification of the left common carotid and left subclavian arteries: a transesophageal echocardiographic approach [see comments]
Katz ES; Konecky N; Tunick PA; Rosenzweig BP; Freedberg RS; Kronzon I
1996 Jan-Feb;9(1):58-61, Journal of the American Society of Echocardiography
— id: 7008, year: 1996, vol: 9, page: 58, stat: Journal Article,

Right atrial thrombus complicating mitral valvuloplasty
Konecky N; Rosenzweig BP; Katz ES; Kronzon I
1996 Oct;132(4):893-894, American heart journal
— id: 7077, year: 1996, vol: 132, page: 893, stat: Journal Article,

Effects of Ca2+ channel blockers on transmitter release and presynaptic currents at the frog neuromuscular junction
Katz E; Ferro PA; Cherksey BD; Sugimori M; Llinas R; Uchitel OD
1995 Aug 1;486(Pt 3):695-706, Journal of physiology
1. The effects of the calcium channel blockers, funnel-web spider toxin (FTX), omega-agatoxin IVA (omega-Aga IVA) and omega-conotoxin GVIA (omega-CgTX), were tested on transmitter release and presynaptic currents in frog motor nerve endings. 2. Evoked transmitter release was blocked by FTX (IC50 = 0.02 microliter ml-1) and omega-CgTX (1 microM) but was not affected by omega-Aga IVA (0.5 microM). When FTX (0.1 microliter ml-1) was assayed on spontaneous release either in normal Ringer solution or in low Ca(2+)-high Mg2+ solution, it was found not to affect miniature endplate potential (MEPP) amplitude but to increase MEPP frequency by approximately 2-fold in both conditions. 3. Presynaptic calcium currents (ICa), measured by the perineurial technique in the presence of 10 mM tetraethylammonium chloride (TEA) and 200 microM BaCl2 to block K+ currents, were blocked by omega-CgTX (5 microM), partially blocked by FTX (1 microliter ml-1) and not affected by omega-Aga IVA (0.5 microM). 4. The presynaptic calcium-activated potassium current (IK(Ca)) measured by the perineurial technique in the presence of 0.5 microM 3,4-aminopyridine (DAP) to block voltage-dependent K+ currents, was strongly affected by charybdotoxin (ChTX) (300 nM) and completely abolished by BaCl2 (200 microM). This current was also blocked by omega-CgTX (5 microM) and by CdCl2 (200 microM) but was not affected by FTX (1 microliter ml-1). The blockade by omega-CgTX could not be reversed by elevating [Ca]o to 10 mM. 5. The results suggest that in frog synaptic terminals two omega-CgTX-sensitive populations might coexist. The transmitter release process seems to be mediated by calcium influx through a omega-CgTX- and FTX-sensitive population
— id: 9890, year: 1995, vol: 486, page: 695, stat: Journal Article,

Echocardiographic evaluation of the coronary sinus
Kronzon I; Tunick PA; Jortner R; Drenger B; Katz ES; Bernstein N; Chinitz LA; Freedberg RS
1995 Jul-Aug;8(4):518-526, Journal of the American Society of Echocardiography
The purpose of this study was to compare transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in the evaluation of the coronary sinus and its blood flow. Forty patients were studied by TTE and TEE. The distal coronary sinus and its right atrial communication could be identified in 21 of 40 by TTE, and in all patients by TEE. Coronary sinus diameter measurement at the right atrial communication was possible by TTE in 16 of 40, and in all patients by TEE (maximal diameter 6 to 14 mm, mean 9 +/- 2). Flow velocity measurement by pulsed Doppler was possible in 25 of 40 patients (63%) by TEE, and in none by TTE. The flow velocity pattern was similar to central vein flow velocity, with systolic and diastolic antegrade waves, and a small retrograde end diastolic wave. The coronary sinus cross-sectional area was measured in 5 patients by intravascular ultrasound. It varied in size and shape during the cardiac cycle, reaching a maximum (0.3 to 1.5 cm2) at end diastole, and decreasing by 40% to 70% at end systole. TEE is superior to TTE in the evaluation of the coronary sinus and its blood flow velocity. However, because of the variability in cross-sectional area size and shape, measurement of coronary sinus blood flow may be inaccurate
— id: 6924, year: 1995, vol: 8, page: 518, stat: Journal Article,

Venous changes occurring during the Valsalva maneuver: evaluation by intravascular ultrasound
Attubato MJ; Katz ES; Feit F; Bernstein N; Schwartzman D; Kronzon I
1994 Aug 15;74(4):408-410, American journal of cardiology
— id: 12917, year: 1994, vol: 74, page: 408, stat: Journal Article,

High risk for vascular events in patients with protruding aortic atheromas: a prospective study
Tunick PA; Rosenzweig BP; Katz ES; Freedberg RS; Perez JL; Kronzon I
1994 Apr;23(5):1085-1090, Journal of the American College of Cardiology
OBJECTIVES. The purpose of this study was to prospectively evaluate the risk of vascular events in patients with protruding aortic atheromas. BACKGROUND. Protruding atheromas of the thoracic aorta have been shown to be associated with embolic disease in previous retrospective studies. METHODS. During a 1-year period, 521 patients had transesophageal echocardiography. Of these, 42 patients had protruding atheromas and no other source of emboli. They were followed up for up to 2 years (mean follow-up 14 months) and compared with a control group without atheromas, matched for age, gender and hypertension. RESULTS. Of 42 patients with atheromas, 14 (33%) had 19 vascular events during follow-up (5 brain, 2 eye, 4 kidney, 1 bowel, 7 lower extremity). Of 42 control patients, 3 (7%) had vascular events (2 brain, 1 eye). Univariate analysis identified only protruding atheromas as significantly correlating with events (p = 0.003). There was no positive correlation of events with age, gender, hypertension, smoking, family history, atrial fibrillation, valve replacement, antithrombotic drug use, diabetes or coronary disease. Multivariate analysis showed that only protruding atheromas independently predicted events (p = 0.005, odds ratio 4.3, 95% confidence interval 1.2 to 15.0). Nine patients died in the atheroma group versus six in the control group, but this was not statistically significant (p = 0.39). CONCLUSIONS. Protruding atheromas seen on transesophageal echocardiography predict future vascular events
— id: 6542, year: 1994, vol: 23, page: 1085, stat: Journal Article,

Aortic dissection complicating cardiac surgery: diagnosis by intraoperative biplane transesophageal echocardiography
Katz ES; Tunick PA; Colvin SB; Culliford AT; Kronzon I
1993 Mar-Apr;6(2):217-222, Journal of the American Society of Echocardiography
Aortic dissection is a rare but devastating complication of cardiopulmonary bypass. Intraoperative transesophageal echocardiography can be a useful technique to define the anatomy of the dissection, to evaluate its extension and progression, and to detect the presence of aortic insufficiency. We describe two cases in which transesophageal echocardiography helped in making a rapid diagnosis of aortic dissection during cardiac surgery and demonstrate how it may play a role in therapeutic decision making
— id: 13221, year: 1993, vol: 6, page: 217, stat: Journal Article,

VENOUS CHANGES OCCURRING DURING THE VALSALVA MANEUVER - AN INTRAVASCULAR ULTRASOUND STUDY
ATTUBATO, MJ; KATZ, ES; FEIT, F; BERNSTEIN, N; SCHWARTZMAN, D; KRONZON, I
1992 OCT ;86(4):871-871, Circulation
— id: 51837, year: 1992, vol: 86, page: 871, stat: Journal Article,

Transesophageal versus transthoracic echocardiography for diagnosing mitral valve perforation
Cziner DG; Rosenzweig BP; Katz ES; Keller AM; Daniel WG; Kronzon I
1992 Jun 1;69(17):1495-1497, American journal of cardiology
— id: 13577, year: 1992, vol: 69, page: 1495, stat: Journal Article,

Diagnosis of tumor embolus to the pulmonary artery by transesophageal echocardiography
Katz ES; Rosenzweig BP; Rorman D; Kronzon I
1992 Jul-Aug;5(4):439-443, Journal of the American Society of Echocardiography
This article describes a patient with renal cell carcinoma and massive tumor extension into the inferior vena cava who experienced sudden tachypnea and subsequent cardiopulmonary arrest. Transesophageal echocardiography was used to diagnose a massive tumor embolus to the pulmonary artery that was subsequently confirmed at autopsy. Transesophageal echocardiography provided a rapid bedside diagnosis of this unusual entity in an acutely ill patient. This technique may prove more widely applicable in the evaluation of patients with suspected pulmonary embolus, whether neoplastic or thromboembolic
— id: 13538, year: 1992, vol: 5, page: 439, stat: Journal Article,

Observations of coronary flow augmentation and balloon function during intraaortic balloon counterpulsation using transesophageal echocardiography
Katz ES; Tunick PA; Kronzon I
1992 Jun 15;69(19):1635-1639, American journal of cardiology
The intraaortic balloon pump has been shown to decrease myocardial oxygen demand by afterload reduction, while increasing myocardial oxygen supply by diastolic augmentation of coronary blood flow. This diastolic augmentation of coronary flow has been demonstrated experimentally with invasive methods. Noninvasively, transesophageal echocardiography has demonstrated efficacy in enabling visualization of the proximal left coronary artery and in recording coronary blood flow velocity. To assess the potential of this technique in demonstrating quantitatively the increase in coronary flow during counterpulsation, 6 patients were studied during intermittent balloon pumping. Peak diastolic coronary blood flow velocity increased by a mean of 117% (range 62 to 287) during balloon inflation (p = 0.002). Furthermore, coronary flow velocity integral increased by a mean of 87% (range 43 to 176; p = 0.003). Problems associated with intraaortic balloon pumping were discovered by transesophageal echocardiography in 4 patients (incorrect balloon placement, damage to the aortic wall [2 patients], and premature balloon deflation time). Transesophageal echocardiography can be used in evaluating intraaortic balloon positioning within the aorta and in monitoring coronary artery flow augmentation during counterpulsation. This relatively noninvasive technique adds another dimension to the evaluation of balloon function and may help in optimizing the benefits of counterpulsation
— id: 13560, year: 1992, vol: 69, page: 1635, stat: Journal Article,

Protruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypass: experience with intraoperative transesophageal echocardiography
Katz ES; Tunick PA; Rusinek H; Ribakove G; Spencer FC; Kronzon I
1992 Jul;20(1):70-77, Journal of the American College of Cardiology
Protruding atheromas of the aortic arch identified by transesophageal echocardiography have been implicated as a cause of stroke in elderly patients. One hundred thirty patients greater than or equal to 65 years of age were studied with intraoperative transesophageal echocardiography to detect aortic arch protruding atheromas and determine if these patients were at higher risk for perioperative stroke. Protruding atheromas were identified in 23 (18%) of 130 patients. In 19 (83%) of these 23 patients, palpation of the aortic arch at operation did not identify significant abnormalities. Five patients (4%) had perioperative stroke. Logistic regression identified aortic arch atheroma as the only historical or procedural variable that was predictive of stroke (odds ratio 5.8, 95% confidence interval 1.2 to 27.9, p less than 0.03). A history of peripheral or cerebrovascular disease, presence of aortic calcification, cardiac risk factors, age and duration of cardiopulmonary bypass did not predict stroke. In contrast, patients with protruding atheromas with mobile components were at highest risk. There were 3 (25%) of 12 patients with a mobile atheroma who had a stroke versus 2 (2%) of 118 patients without a mobile atheroma (chi-square = 10.3, p = 0.001). Displacement and detachment of the frail, protruding atherosclerotic material by aortic arch cannulation or by the high pressure jet emanating from the cannula tip may play an important role in the creation of embolization and stroke
— id: 13531, year: 1992, vol: 20, page: 70, stat: Journal Article,

IDENTIFICATION OF AN UNUSUAL RIGHT ATRIAL MASS AS A CHIARI NETWORK BY BIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY
KATZ, ES; FREEDBERG, RS; RUTKOVSKY, L; MARTIN, JC; KRONZON, I
1992 MAY ;9(3):273-275, Echocardiography
An unusual right atrial mass was visualized on the transthoracic and single planar transesophageal echocardiograms of a young female patient. Biplane transesophageal echocardiography, however, clearly demonstrated this structure to be a prominent Chiari network. Large eustachian valves and Chiari networks may mimic tumor or thrombus formation when conventional noninvasive diagnostic techniques are used. Multiplanar imaging can be essential in defining anatomical relationships of normal variant structures, eliminating concern for pathological entities and the need for further invasive work-up
— id: 51961, year: 1992, vol: 9, page: 273, stat: Journal Article,

INCOMPLETE LIGATION OF THE LEFT ATRIAL APPENDAGE - DIAGNOSIS BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY
KATZ, ES; KRONZON, I
1992 JUL-AUG ;6(4):262-263, American journal of noninvasive cardiology
Ligation of the left atrial appendage during mitral valve surgery is routinely performed to decrease the incidence of future thromboembolic events. Complete obliteration of the appendage cavity is the surgical aim, but this has been difficult to verify by objective means. In this paper, we report 2 cases of incomplete left atrial appendage ligation detected incidentally by transesophageal echocardiography and speculate on the clinical relevance of this finding
— id: 51911, year: 1992, vol: 6, page: 262, stat: Journal Article,

Buckling of the tip of the transesophageal echocardiography probe: a potentially dangerous technical malfunction
Kronzon I; Cziner DG; Katz ES; Gargiulo A; Tunick PA; Freedberg RS; Daniel WG
1992 Mar-Apr;5(2):176-177, Journal of the American Society of Echocardiography
— id: 13669, year: 1992, vol: 5, page: 176, stat: Journal Article,

Surgical implications of transesophageal echocardiography to grade the atheromatous aortic arch
Ribakove GH; Katz ES; Galloway AC; Grossi EA; Esposito RA; Baumann FG; Kronzon I; Spencer FC
1992 May;53(5):758-761, Annals of thoracic surgery
Stroke is an especially serious complication of cardiopulmonary bypass with an incidence of 2% to 5%. This prospective study used transesophageal echocardiography (TEE) in 97 patients more than 65 years of age (mean age, 73 years) to identify those at high risk for aortic atheroemboli. The atheromatous disease of the aorta was graded by TEE: grade I = minimal intimal thickening (n = 29); II = extensive intimal thickening (n = 33); III = sessile atheroma (n = 15); IV = protruding atheroma (n = 10); V = mobile atheroma (n = 10). Clinical evaluation was also performed by intraoperative aortic palpation. Four patients who were graded as having normal aortas by palpation had intraoperative strokes. In contrast, 3 of these 4 patients were in grade V on TEE. The relationship of TEE to incidence of stroke was statistically significant (p less than 0.006), whereas there was no significant correlation between clinical grade and stroke incidence. Four of 10 TEE grade V patients were treated with hypothermic circulatory arrest and aortic arch debridement, and none suffered strokes. The other 6 patients were treated with standard techniques, and 3 had strokes. These results suggest that patients with mobile atheromatous disease are at high risk for embolic strokes that are not predicted by routine clinical evaluation. Selective use of circulatory arrest in the presence of TEE-detected mobile arch atheromas may reduce the risk of intraoperative stroke
— id: 13614, year: 1992, vol: 53, page: 758, stat: Journal Article,

Association between residual mitral regurgitation and left ventricular outflow obstruction after Carpentier ring mitral annuloplasty
Tunick PA; Cziner DG; Katz ES; Perez JL; Kronzon I
1992 Sep 1;70(6):689-691, American journal of cardiology
— id: 13449, year: 1992, vol: 70, page: 689, stat: Journal Article,

Multiple emboli from a large aortic arch thrombus in a patient with thrombotic diathesis
Tunick PA; Lackner H; Katz ES; Culliford AT; Giangola G; Kronzon I
1992 Jul;124(1):239-241, American heart journal
— id: 13529, year: 1992, vol: 124, page: 239, stat: Journal Article,

Multifaceted echocardiographic approach to the diagnosis of a ruptured sinus of Valsalva aneurysm
Katz ES; Cziner DG; Rosenzweig BP; Attubato M; Feit F; Kronzon I
1991 Sep-Oct;4(5):494-498, Journal of the American Society of Echocardiography
— id: 13927, year: 1991, vol: 4, page: 494, stat: Journal Article,

To-and-fro left ventricular-to-right atrial shunting after valve replacement shown by transesophageal echocardiography
Katz ES; Tunick PA; Kronzon I
1991 Jan;121(1 Pt 1):211-214, American heart journal
— id: 14176, year: 1991, vol: 121, page: 211, stat: Journal Article,

Echocardiographic diagnosis of secondary coarctation complicating the repair of a traumatic pseudoaneurysm of the aorta
Weitz SH; Gindea AJ; Katz ES; Kronzon I
1991 Jul-Aug;4(4):393-396, Journal of the American Society of Echocardiography
An 18-year-old patient underwent repair of traumatic aortic pseudoaneurysm. Postoperatively, the physical examination showed hypertension with 30 mm Hg gradient between the upper and lower extremities. Doppler echocardiographic evaluation demonstrated a new (secondary) aortic coarctation at the site of the repair. Transesophageal echocardiography revealed the detailed anatomy and the cross-sectional area of the coarctation
— id: 13977, year: 1991, vol: 4, page: 393, stat: Journal Article,

Spatial and temporal analysis by neurons in the representation of the central visual field in the cat's lateral suprasylvian visual cortex
Gizzi, M S; Katz, E; Movshon, J A
1990 Nov;5(5):463-468, Visual neuroscience
We studied quantitatively the receptive-field properties of 74 units recorded from the representation of the central visual fields in the cat's lateral suprasylvian (LS) visual cortex. In agreement with previous workers, we found that LS receptive fields tended to be large and to lack discernible spatial structure. They resembled the complex receptive fields of areas 17 and 18 in their general organization. We examined the responses of these neurons to moving optimally oriented sinusoidal gratings that varied in spatial and temporal frequency of drift. Most LS neurons were selective for the spatial frequency of sinusoidal gratings; 7% responded to all spatial frequencies below a cutoff value. In agreement with previous reports, the optimal spatial frequencies for LS neurons covered a wider range than is seen in either area 17 or 18 alone (0.05-1 cycle/deg), but are certainly included in the range covered by both these afferent areas. Individual neurons in LS responded to a range of spatial frequencies broader than is typical for neurons in areas 17 and 18. The effect of varying the drift rate of otherwise optimal gratings was similar in LS to that reported for areas 17 and 18. Most neurons were optimally responsive to drift rates between 0.5 and 4 Hz, and resolved frequencies as high as 10-30 Hz. A few neurons had optima higher than 6 Hz and resolved frequencies in excess of 30 Hz. We conclude that the receptive fields of LS neurons reflect rather closely the properties of their afferents from areas 17 and 18.(ABSTRACT TRUNCATED AT 250 WORDS)
— id: 113039, year: 1990, vol: 5, page: 463, stat: Journal Article,

Selectivity for orientation and direction of motion of single neurons in cat striate and extrastriate visual cortex
Gizzi, M S; Katz, E; Schumer, R A; Movshon, J A
1990 Jun;63(6):1529-1543, Journal of neurophysiology
1. We consider the consequences of the orientation selectivity shown by most cortical neurons for the nature of the signals they can convey about the direction of stimulus movement. On theoretical grounds we distinguish component direction selectivity, in which cells are selective for the direction of movement of oriented components of a complex stimulus, from pattern direction selectivity, or selectivity for the overall direction of movement of a pattern irrespective of the directions of its components. We employed a novel test using grating and plaid targets to distinguish these forms of direction selectivity. 2. We studied the responses of 280 cells from the striate cortex and 107 cells from the lateral suprasylvian cortex (LS) to single sinusoidal gratings to determine their orientation preference and directional selectivity. We tested 73 of these with sinusoidal plaids, composed of two sinusoidal gratings at different orientations, to study the organization of the directional mechanisms within the receptive field. 3. When tested with single gratings, the directional tuning of 277 oriented cells in area 17 had a mean half width of 20.6 degrees, a mode near 13 degrees, and a range of 3.8-58 degrees. Simple cells were slightly more narrowly tuned than complex cells. The selectivity of LS neurons for the direction of moving gratings is not markedly different from that of neurons in area 17. The mean direction half width was 20.7 degrees. 4. We evaluated the directional selectivity of these neurons by comparing responses to stimuli moved in the optimal direction with those elicited by a stimulus moving in the opposite direction. In area 17 about two-thirds of the neurons responded less than half as well to the non-preferred direction as to the preferred direction; two-fifths of the units responded less than one-fifth as well. Complex cells showed a somewhat greater tendency to directional bias than simple cells. LS neurons tended to have stronger directional asymmetries in their response to moving gratings: 83% of LS neurons showed a significant directional asymmetry. 5. Neurons in both areas responded independently to each component of the plaid. Thus cells giving single-lobed directional-tuning curves to gratings showed bilobed plaid tuning curves, with each lobe corresponding to movement in an effective direction by one of the two component gratings within the plaid. The two best directions for the plaids were those at which one or other single grating would have produced an optimal response when presented alone.(ABSTRACT TRUNCATED AT 400 WORDS)
— id: 113040, year: 1990, vol: 63, page: 1529, stat: Journal Article,

EFFECT OF COLLATERAL VESSELS ON EXERCISE TEST-PERFORMANCE IN SEVERE SINGLE VESSEL CORONARY-ARTERY DISEASE
Katz, E; Kaplan, B; Perez, J; Slater, J; Glassman, E; Rey, M; Slater, W
1990 Oct;38(3):A764-A764, Clinical research
— id: 31919, year: 1990, vol: 38, page: A764, stat: Journal Article,

Right atrial papillary fibroelastoma: diagnosis by transthoracic and transesophageal echocardiography and percutaneous transvenous biopsy
Schwinger ME; Katz E; Rotterdam H; Slater J; Weiss EC; Kronzon I
1989 Nov;118(5 Pt 1):1047-1050, American heart journal
— id: 10431, year: 1989, vol: 118, page: 1047, stat: Journal Article,