Transoesophageal echocardiography

ESC CardioMed ◽  
2018 ◽  
pp. 447-450
Author(s):  
Ruxandra Beyer ◽  
Frank A. Flachskampf
Keyword(s):  
Cardiac Surgery ◽  
Intraoperative Monitoring ◽  
Left Atrial ◽  
Aortic Valve Disease ◽  
Transoesophageal Echocardiography ◽  
Atrial Septum ◽  
Clinical Question ◽  
Aortic Diseases ◽  
Prosthetic Valves ◽  
Morphological Evaluation

Transoesophageal echocardiography uses the oesophagus and upper stomach as echo windows on the heart and thoracic vessels via an endoscopic probe. It is indicated when transthoracic echocardiography is unable or unlikely to answer the clinical question. Indications where transoesophageal echocardiography has a proven superiority include diagnosis of left atrial and appendage thrombi, morphological evaluation of the atrial septum, infective endocarditis, in particular abscesses, mitral and aortic valve disease, prosthetic valves, aortic diseases, and intraoperative monitoring of cardiac surgery or interventions.

Transoesophageal echocardiography

2016 ◽  
Author(s):  
Frank A. Flachskampf ◽  
Mauro Pepi ◽  
Silvia Gianstefani
Keyword(s):  
Intraoperative Monitoring ◽  
Left Atrial ◽  
Septal Defect ◽  
Transoesophageal Echocardiography ◽  
Clinical Question ◽  
Aortic Diseases ◽  
Prosthetic Valves ◽  
Morphological Evaluation ◽  
Echocardiographic Technique ◽  
Atrial Thrombi

Transoesophageal echocardiography (TOE) is a standard echocardiographic technique which uses the oesophagus and upper stomach as echo windows on the heart and thoracic vessels via an endoscopic probe. It is indicated when transthoracic echocardiography is unable or unlikely to answer the clinical question. Typical indications where TOE has a proven superiority include diagnosis of left atrial thrombi, especially in the appendage, morphological evaluation of atrial septal defect, infective endocarditis, mitral valve disease, aortic and prosthetic valves, aortic diseases, and intraoperative monitoring of cardiac surgery or interventions. Indications, technique, typical views, and information to obtain in specific scenarios are presented.

Cobra head deformity of atrial septal occluder: blessing in disguise

2020 ◽  
pp. 1-2
Author(s):  
Uma Devi Karuru ◽  
Saurabh Kumar Gupta
Keyword(s):  
Atrial Septal Defect ◽  
Left Atrial ◽  
Septal Defect ◽  
Atrial Septum ◽  
Right Atrial ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
The Right

Abstract It is not uncommon to have prolapse of the atrial septal occluder device despite accurate measurement of atrial septal defect and an appropriately chosen device. This is particularly a problem in cases with large atrial septal defect with absent aortic rim. Various techniques have been described for successful implantation of atrial septal occluder in such a scenario. The essence of all these techniques is to prevent prolapse of the left atrial disc through the defect while the right atrial disc is being deployed. In this brief report, we illustrate the use of cobra head deformity of the device to successfully deploy the device across the atrial septum.

scholarly journals Metabolomics in Severe Aortic Stenosis Reveals Intermediates of Nitric Oxide Synthesis as Most Distinctive Markers

2021 ◽  
Vol 22 (7) ◽  
pp. 3569
Author(s):  
Beau Olivier van van Driel ◽  
Maike Schuldt ◽  
Sila Algül ◽  
Evgeni Levin ◽  
Ahmet Güclü ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Cardiac Surgery ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Western Blot ◽  
Aortic Valve Disease ◽  
Metabolic Profile ◽  
Valve Disease ◽  
Healthy Controls ◽  
Calcific Aortic Valve Disease

Background: Calcific aortic valve disease (CAVD) is a rapidly growing global health problem with an estimated 12.6 million cases globally in 2017 and a 112% increase of deaths since 1990 due to aging and population growth. CAVD may develop into aortic stenosis (AS) by progressive narrowing of the aortic valve. AS is underdiagnosed, and if treatment by aortic valve replacement (AVR) is delayed, this leads to poor recovery of cardiac function, absence of symptomatic improvement and marked increase of mortality. Considering the current limitations to define the stage of AS-induced cardiac remodeling, there is need for a novel method to aid in the diagnosis of AS and timing of intervention, which may be found in metabolomics profiling of patients. Methods: Serum samples of nine healthy controls and 10 AS patients before and after AVR were analyzed by untargeted mass spectrometry. Multivariate modeling was performed to determine a metabolic profile of 30 serum metabolites which distinguishes AS patients from controls. Human cardiac microvascular endothelial cells (CMECs) were incubated with serum of the AS patients and then stained for ICAM-1 with Western Blot to analyze the effect of AS patient serum on endothelial cell activation. Results: The top 30 metabolic profile strongly distinguishes AS patients from healthy controls and includes 17 metabolites related to nitric oxide metabolism and 12 metabolites related to inflammation, in line with the known pathomechanism for calcific aortic valve disease. Nine metabolites correlate strongly with left ventricular mass, of which three show reversal back to control values after AVR. Western blot analysis of CMECs incubated with AS patient sera shows a significant reduction (14%) in ICAM-1 in AS samples taken after AVR compared to AS patient sera before AVR. Conclusion: Our study defined a top 30 metabolic profile with biological and clinical relevance, which may be used as blood biomarker to identify AS patients in need of cardiac surgery. Future studies are warranted in patients with mild-to-moderate AS to determine if these metabolites reflect disease severity and can be used to identify AS patients in need of cardiac surgery.

Abstract 1357: Mobility of Epicardial Rotors During Human Ventricular Fibrillation

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Martyn P Nash ◽  
Ayman Mourad ◽  
Chris P Bradley ◽  
David J Paterson ◽  
Peter M Sutton ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Surgery ◽  
Aortic Valve Disease ◽  
Singularity Analysis ◽  
Epicardial Mapping ◽  
Voltage Versus ◽  
Phase Singularity ◽  
The Mean ◽  
Artery Disease ◽  
Contact Electrodes

Introduction: Stability of reentry during VF may depend on the dynamics of rotor cores. We determined the mobility of rotors during human VF using global epicardial mapping and phase singularity analysis. Methods: In 10 patients undergoing cardiac surgery (6 with coronary artery disease; 4 with aortic valve disease), VF was induced by burst pacing prior to (n=7) or immediately following (n=3) the onset of cardiopulmonary bypass. For each subject, a 20 – 40 s episode of fibrillatory activity was sampled at 1 kHz using an epicardial sock containing 256 unipolar contact electrodes connected to a UnEmap system. Trajectories of persistent epicardial rotors (singularities of phase maps, based on de-trended voltage versus its Hilbert transform, lasting for > 1000 ms) were tracked. The mean core location was determined across the lifetime of each persistent rotor. The rotor was classified as stationary if its core remained within 15 mm of the mean location for more than 90% of its duration. Results: Using the above criteria, the numbers of mobile and stationary rotors varied from patient-to-patient (see figure ). In all but one patient, there were more mobile than stationary rotors. Over all patients, the mean ± SD number of mobile rotors (32 ± 21) was significantly greater than stationary rotors (7 ± 6, P<0.01). Conclusions: At least one stationary rotor was always present during human VF, but it is predominantly characterised by a small number of persistent mobile rotors.

Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke

2021 ◽  
Author(s):  
Richard P. Whitlock ◽  
Emilie P. Belley-Cote ◽  
Domenico Paparella ◽  
Jeff S. Healey ◽  
Katheryn Brady ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion
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