The growth of transcatheter structural heart disease interventions has created a subspecialty of interventional imagers who focus on preprocedural planning and the periprocedural guidance of these ...complex cases. In particular interventional imagers who focus on periprocedural guidance have developed a specific expertise in interventional transesophageal echocardiography (iTEE). This nascent field has challenges in training, reimbursement, and occupational hazards which are unique to this field. This review encompasses the evolution of iTEE, current challenges, and future opportunities.
Background:To take full advantage of transesophageal echocardiography (TEE) during cardiopulmonary resuscitation (CPR), we propose a flowchart derived from representative cases.Methods and ...Results:TEE was used in patients requiring CPR to obtain information potentially helpful for rescue. TEE navigated the CPR procedures (navigation TEE), identified the possible cause of arrest (focus TEE), and optimized treatment while checking for pitfalls (secure TEE). In addition, TEE corrected prehospital misdiagnoses and detected new complications caused by CPR.Conclusions:TEE provides valuable information without interrupting CPR procedures. It is hoped that our flowchart may facilitate goal-directed, efficient assessment.
Orthotopic liver transplantation (OLT) is characterized by significant hemodynamic disturbances and anesthetic challenges. Intraoperative transesophageal echocardiography (TEE) can be used to guide ...management during these procedures. This review examines the role of echocardiography during OLT, presents common TEE findings during each phase of OLT, and discusses the benefits demonstrated with TEE use and the safety of TEE in this patient population. Finally, the authors propose an algorithm for the safe use of TEE during OLT.
In vivo exclusion of giant aortic thrombus Baltodano‐Arellano, Roberto; Zuñiga‐Luna, Carlos; Cachicatari‐Beltran, Angela ...
Echocardiography (Mount Kisco, N.Y.),
November 2022, Letnik:
39, Številka:
11
Journal Article
Recenzirano
We present the case of a 53‐year‐old patient with a giant floating thrombus in the aortic arch associated with proximal stenosis of the left subclavian artery diagnosed by multimodal imaging. Left ...carotid‐subclavian shunt and thoracic endovascular aortic repair (TEVAR) were successful. Transesophageal echocardiography (TEE) played a substantial role in the safety and efficacy of the endovascular procedure and should be considered as an additional guide to fluoroscopy for this type of procedure.
A new hospital – a new beginning Jelinić, Marina; Pereša, Tatjana
Cardiologia Croatica,
12/2022, Letnik:
17, Številka:
9-10
Journal Article, Web Resource
Patients with dilated cardiomyopathy who have developed mitral valve regurgitation (MR) with reduced left ventricular ejection fraction and are too sick to undergo any surgical repair or replacement ...are being treated worldwide through catheter-based percutaneous intervention techniques to treat MR like MitraClip system®. There are very few case reports especially from India on anesthetic management during MitraClip device implantation and its specific considerations. We present a case of a 48-year-old male patient, diagnosed as post-myocarditis dilated cardiomyopathy with poor left ventricular ejection fraction (30-35%) and severe MR who underwent mitral clip implantation with fluoroscopy and transesophageal echocardiography guidance under general anesthesia. We hope that our experience will help and guide future such undertakings in our country.
Staphylococcus lugdunensis, a minor species of coagulase-negative staphylococci, has attracted attention because of its formidable pathogenicity. We present a case of infective endocarditis (IE) ...caused by S. lugdunensis in a 72-year-old woman with a history of breast cancer and metastases who presented with fever. Two of two blood culture bottles were positive for gram-positive cocci. Transesophageal echocardiography revealed vegetation attached to the right cusp of the aortic valve and an abscess in the annulus, which was less evident on transthoracic echocardiography. This case underscores the importance of considering S. lugdunensis as a potential cause of IE.
3D transesophageal echocardiography in TAVR Bleakley, Caroline; Monaghan, Mark
Echocardiography (Mount Kisco, N.Y.),
October 2020, 2020-10-00, 20201001, Letnik:
37, Številka:
10
Journal Article
Recenzirano
Recently, there has been an increasingly minimalistic approach to transcatheter aortic valve replacement (TAVR), with most procedures now performed under conscious sedation without real time ...transesophageal echocardiography (TEE) guidance. Proponents of echo should not feel discouraged by this; it is the initial insights that were gained with procedural TEE during the early years of TAVR that have allowed the procedure's gradual maturation and sophistication. Experienced centers that have promoted extensive TAVR TEE programs continue to maximize the benefits of echocardiography in both procedural planning and execution. Critical to this is the understanding of 3D TEE, allowing the annulus to be sized accurately, relevant neighboring anatomy defined, and complications flagged. This review will outline the current application of 3D TEE in TAVR and discuss challenges and opportunities for 3D echocardiography in this field.
Current trends have suggested covert atrial fibrillation as a mechanism of cryptogenic stroke. However, etiological heterogeneity regarding the underlying embolic sources remains a critical issue in ...cryptogenic stroke.
CHALLENGE ESUS/CS (Mechanisms of Embolic Stroke Clarified by Transesophageal Echocardiography for Embolic Stroke of Undetermined Source/Cryptogenic Stroke) is a multicenter observational registry of cryptogenic stroke patients admitted to participating hospitals, who underwent transesophageal echocardiography between April 2014 and December 2016. We obtained baseline characteristics, radiological and laboratory data, and echocardiographic findings, especially for embolic sources demonstrated on transesophageal echocardiography, and conducted comparisons according to CHADS
and CHA
DS
-VASc scores (0-1 vs. ≥2, respectively). This study was registered at http://www.umin.ac.jp/ctr/(UMIN000032957).
The study comprised 677 patients (age, 68.7 ± 12.8 years; 455 males; median National Institutes of Health Stroke Scale score, 2) with cryptogenic stroke. On multiple logistic regression analysis, large aortic arch plaque ≥4 mm (odds ratio OR, 2.25; 95% confidence interval CI, 1.51-3.36; p < 0.001), with ulcerative or mobile components (OR, 2.37; 95%CI, 1.38-4.06; p = 0.002), was associated with CHADS
score ≥2. Large aortic arch plaque ≥4 mm (OR, 3.88; 95%CI, 2.07-7.27; p < 0.001) and ulcerative or mobile components (OR, 3.25; 95%CI, 1.44-7.34; p = 0.005) were linked to CHA
DS
-VASc score ≥2.
The CHALLENGE ESUS/CS registry is a large TEE registry, and clarifies potential embolic etiologies of cryptogenic stroke using TEE. Large aortic arch plaques were associated with high CHADS
and CHA
DS
-VASc scores, and represented important embolic sources in cryptogenic stroke.
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