DK2985_C000 1..28 - AlSharqia Echo Club

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<strong>Echo</strong>cardiography During Cardiac Surgery 289in patients with a history of transient ischemic attacks,stroke, severe peripheral vascular disease, palpable calcificationsin the ascending Ao, calcified aortic knob onCXR, and those older than 60 years (15).Focal areas of moderate to severe atheromas withthickness .3 mm located in the surgical field warrantchange in operative technique to avoid manipulation anddisruption of these lesions (see Figs. 12.13 and 12.14).More aggressive management of severe extensivedisease, especially protuding plaques, is more controversialbecause the changes in technique often involve deephypothermic circulatory arrest and atherectomy or aorticreplacement (15).D. Coronary Sinus CatheterThe technique for inserting the retrograde cardioplegiacatheter from the internal jugular vein has been describedusing the Port-access system (Heartport Inc., RedwoodCity, CA). Transesophageal echocardiography has beenused to visualize the catheter entering the coronary sinusorifice. Fluoroscopy is then used to advance the wire andcatheter to the correct depth. The coronary sinus can bevisualized from a four-chamber view at a lower esophageallevel at 08 in which it appears longitudinally(Fig. 13.4). However, catheter guidance is best performedusing the bicaval view at 1008 (Fig. 13.5 A, B) while locatingthe orifice of the sinus from this plane: as the inferiorvena cava (IVC) is visualized, the probe shaft is rotatedtowards the patient’s left; the coronary sinus can beidentified following its course in the left atrioventriculargroove where it appears in cross-section as a circular structure.A transgastric right ventricular longitudinal view at908 may also be used to visualize the coronary sinus(Fig. 13.5 C, D). Simultaneous visualization of bothSVC and coronary sinus is often facilitated by changingthe viewing angle to 1108 or more. The coronary sinusmust be distinguished from the IVC, which is twice asbroad in diameter, located to the right of the coronarysinus and leads to the liver (18).Insertion of a coronary sinus catheter from the RA ismost often uncomplicated and its position, easily confirmedby palpation and pressure tracing measurements.However, difficult insertion may be anticipated whenFigure 13.4 Coronary sinus (CS) visualization. (A, B) Lower esophageal view at 08: longitudinal view of the CS in the left posterioratrioventricular groove near the gastroesophageal junction. (C) Intraoperative view of the CS in a 56-year-old woman before tricuspidannuloplasty through right atriotomy. The suctionning device is in the CS (LV, left ventricle; RA, right atrium; RV, right ventricle).(Photo C courtesy of Dr. Louis P. Perrault.)
290 Transesophageal <strong>Echo</strong>cardiography(A)(B)LAIVCSVCRA(C)(D)CSRVRAFigure 13.5 (A, B) Bicaval view showing the retrograde cardioplegia cannula positioned toward the atrial septum through the patentforamen ovale. (C, D) Transgastric 888 view of the right ventricle (RV) and coronary sinus (CS) (IVC, inferior vena cava; LA, left atrium;RA, right atrium; SVC, superior vena cava). (Photo A courtesy of Dr. Baqir Qizilbash.)(A) (B) (C)RETROGRADECANNULACATHETERCSLVRV(D)(E) SUCTION IN THE CSCSTHEBESIUS TENDONTHEBESIUS VALVEFigure 13.6 A re-operation on the mitral valve is planned on this 23-year-old man. (A–C) The retrograde cannula cannot be inserted inthe coronary sinus (CS). This was secondary to ostial stenosis of the CS, maybe from a previous cannulation or from a large Thebesiusvalve. A secondary CS flow acceleration is demontrated with color Doppler. (D, E) Intraoperative aspect of two types of Thebesius valveat the ostium of the CS: the first is a rudimentary small ligament (D) and the second (E) a more developed valve (LV, left ventricle;RV, right ventricle). (Photos D and E courtesy of Dr. Michel Pellerin.)
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TransesophagealEchocardiographyMult
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Published in 2005 byTaylor & Franci
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ForewordThe use of transesophageal
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xPrefaceThere are several other ind
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ContentsForeword Jean-Francois Hard
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ContributorsRobert Amyot, MD, FRCPC
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ContributorsxviiFrançois Marcotte,
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xxAbbreviationsCNS central nervous
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xxiiAbbreviationsPMLPpaPPHPPHTNPraP
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How to Use the Transesophageal Echo
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1Principles of UltrasoundALAIN GAUV
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Principles of Ultrasound 3Table 1.1
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Principles of Ultrasound 5the ratio
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Principles of Ultrasound 7transduce
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Principles of Ultrasound 9(A)(B)Fig
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Principles of Ultrasound 11certain
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Principles of Ultrasound 13PULSERBE
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Principles of Ultrasound 152. Trans
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Principles of Ultrasound 17(A)(B)TV
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Principles of Ultrasound 19(A)(B)(E
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Principles of Ultrasound 21to the i
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24 Transesophageal Echocardiography
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3TransducersFRANÇOIS HADDADUnivers
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Transducers 43(A)(C)(B)Figure 3.3 (
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Transducers 45more frequencies than
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Transducers 47Figure 3.10 Beam focu
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Transducers 49sound that propagate
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Transducers 51(A)(B)(C)Figure 3.15
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5Quantitative EchocardiographyJEAN
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Quantitative Echocardiography 91dim
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Quantitative Echocardiography 93Fig
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Quantitative Echocardiography 101Fi
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Quantitative Echocardiography 105in
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Quantitative Echocardiography 115On
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Quantitative Echocardiography 117Ha
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Quantitative Echocardiography 119fl
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6Imaging Artifacts and PitfallsROBE
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Imaging Artifacts and Pitfalls 123F
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Imaging Artifacts and Pitfalls 125F
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Imaging Artifacts and Pitfalls 127(
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Imaging Artifacts and Pitfalls 1391
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142 Transesophageal Echocardiograph
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9Global Ventricular Function and He
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Global Ventricular Function and Hem
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10CardiomyopathyVICKY SOULIÈRE, PH
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Cardiomyopathy 217Figure 10.1 (A, B
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Cardiomyopathy 219Figure 10.4 Systo
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Cardiomyopathy 221RVOT must also be
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Cardiomyopathy 223either by reduced
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Cardiomyopathy 225Figure 10.10 Flow
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Cardiomyopathy 227On the other hand
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Cardiomyopathy 229volumes are both
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Cardiomyopathy 231(A)TMFAE(B)PVFDMe
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Cardiomyopathy 233(A)(B)LUPVLAAoLAA
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Cardiomyopathy 235(A)(B)LALV(C)Figu
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Cardiomyopathy 237than moderate MR
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Page 290 and 291: 12AortaIVAN IGLESIAS, DANIEL BAINBR
Page 292 and 293: Aorta 263GRADE 1:NORMALAoGRADE 2:IN
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Page 310 and 311: Aorta 281(A)(B)FLTLAo(C)(D)INTRALUM
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Page 344 and 345: 14Perioperative Role of TEE in Mech
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Page 358 and 359: 15Native Aortic ValveFRANÇOIS A. B
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Native Aortic Valve 339(A)(B)MVAoVL
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Native Aortic Valve 341(A)(B)LAAoVL
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Native Aortic Valve 343(A)(B)SAMLAI
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Native Aortic Valve 345(A)(B)AoVLAT
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Native Aortic Valve 347Although the
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Native Aortic Valve 349substitution
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Native Aortic Valve 351(A)(B)AoVLVO
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Native Aortic Valve 353(A)(B)LARPAL
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Native Aortic Valve 355(A)(B)LAAoVR
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Native Aortic Valve 357In those pat
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Native Aortic Valve 359Table 15.4 E
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Native Aortic Valve 36111. Levine R
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17Mitral ValveANDRÉ SAINT-PIERRELa
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Mitral Valve 385(A)SCHEMATIC VIEW(B
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Mitral Valve 387Figure 17.5 Echocar
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Mitral Valve 389(A)(B)LVP3A2LAAA1Fi
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Mitral Valve 391(A)(B)(C)(D)A1LAP1L
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Mitral Valve 393(A)(B)LARALVRV(C)(D
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Mitral Valve 395(A)(B)AoVFLAIL P1LA
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Mitral Valve 397(A)(B)P3LALVLAAA1(C
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Mitral Valve 399(A)(B)LALAALV(C)(D)
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Mitral Valve 401Table 17.3Mitral Re
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Mitral Valve 403(A)(B)MITRAL VALVEV
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Mitral Valve 405(A)EKG(B)PVFPaSDRES
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Mitral Valve 407Table 17.4BVR Echoc
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Mitral Valve 409Left ventricular sy
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Mitral Valve 411(A)(B)LALVAoRV(C)TM
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Mitral Valve 413Table 17.8StenosisT
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Mitral Valve 415identification of a
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19Pulmonic and Tricuspid ValvesFRAN
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Pulmonic and Tricuspid Valves 449Ta
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Pulmonic and Tricuspid Valves 451(A
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Pulmonic and Tricuspid Valves 459ti
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Pulmonic and Tricuspid Valves 463AN
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Pulmonic and Tricuspid Valves 46939
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23Intracavitary ContentsMARIA DI LO
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Intracavitary Contents 499(A)(B)PFO
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Intracavitary Contents 501(A)(B)LAL
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Intracavitary Contents 503artery ca
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Intracavitary Contents 505(A)(B)MYX
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Intracavitary Contents 507(A)(B)LVL
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Intracavitary Contents 509(A)(B)THY
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Intracavitary Contents 511wall clos
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Intracavitary Contents 513(A)(B)LAR
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Intracavitary Contents 515(A)(B)PER
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Intracavitary Contents 517dysfuncti
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Intracavitary Contents 519endocardi
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Intracavitary Contents 521and angle
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Intracavitary Contents 52317. Lando
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25Indications for Perioperative Tra
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Indications for Perioperative TEE 5
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570 IndexAortic aneurysmclassificat
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572 IndexColor jet area, 402Commiss
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574 IndexHypotension, 491Hypothermi
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576 IndexMitral valve repair, 394,
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578 IndexRight atrial thrombus, 517
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580 IndexTricuspid leafletsanterior
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DK2985_C000 1..28 - AlSharqia Echo Club

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