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Transoesophageal echocardiography

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https://www.readbyqxmd.com/read/28340160/safety-of-fluoroscopy-guided-transseptal-approach-for-ablation-of-left-sided-arrhythmias
#1
Zviad Matoshvili, Hamid Bastani, Tara Bourke, Frieder Braunschweig, Nikola Drca, Kristjan Gudmundsson, Per Insulander, Anette Jemtrén, Göran Kennebäck, Ott Saluveer, Jonas Schwieler, Jari Tapanainen, Christer Wredlert, Mats Jensen-Urstad
Aims: The transseptal approach is used for left atrial access during the ablation of atrial fibrillation (AF) and other left-sided arrhythmia substrates. Transseptal puncture (TP) is commonly performed with fluoroscopic guidance, contrast injection, and pressure monitoring. In many centres, additional techniques [intracardiac echocardiography (ICE), transoesophageal echocardiography (TEE), radiofrequency needle] are used to facilitate TP but its use adds costs. In this retrospective study, we studied the safety and complication rate when TP was routinely done with fluoroscopic guidance, contrast injection, and pressure monitoring using ICE or TEE only in selected cases...
March 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340095/non-laser-percutaneous-extraction-of-pacemaker-and-defibrillation-leads-a-decade-of-progress
#2
Giulia Domenichini, Hanney Gonna, Rajan Sharma, Sergio Conti, Lorenzo Fiorista, Sue Jones, Maria Arthur, Shaumik Adhya, Marjan Jahangiri, Edward Rowland, Mark M Gallagher
Aims: Non-laser-based methods are safe in lead extraction but in the past have been less effective than laser methods. In the past decade, new equipment has been introduced including the Evolution® Mechanical Dilator Sheath and the Evolution® RL. We sought to determine the impact of new equipment on outcome in mechanical lead extraction. Methods and results: We considered 288 consecutive patients (age 66 ± 18 years) who underwent transvenous lead extraction (TLE) of 522 leads in the decade to the end of 2014...
March 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340073/left-atrial-appendage-isolation-in-addition-to-pulmonary-vein-isolation-in-persistent-atrial-fibrillation-one-year-clinical-outcome-after-cryoballoon-based-ablation
#3
Hikmet Yorgun, Ugur Canpolat, Duygu Kocyigit, Cem Çöteli, Banu Evranos, Kudret Aytemir
Aims: In this study, we sought to evaluate the safety and efficacy of cryoballoon (CB) based empirical left atrial appendage (LAA) isolation as an adjunct to pulmonary vein isolation (PVI) compared to the PVI-only strategy in patients with persistent AF. Objectives: Clinical outcomes of catheter ablation were less beneficial for persistent atrial fibrillation (AF) than paroxysmal AF. Methods and results: A total of 100 consecutive patients with persistent AF underwent both PVI and additional LAA isolation using CB (Group II)...
March 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28336529/toe-imaging-of-a-large-aortic-mass-an-unusual-cause-of-systemic-embolization-in-a-septic-patient
#4
Sarah R Blake, Jamal Khan, Adrian Chenzbraun
A 72-year-old woman presented with sepsis and lower limb ischaemia. Transoesophageal echocardiography (TOE) for suspected endocarditis revealed no cardiac pathology or source of emboli but a large thrombus-like mass was noted in a normal size descending aorta (Fig. 1A, Video 1). Repeat TOE after two weeks of anticoagulation showed two new masses and no change in the size of the original one (Fig. 1B). The patient died following bilateral leg amputation. There was no PM to provide pathology confirmation but the most likely diagnosis was of a thrombus, possibly infected...
March 23, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28329276/demonstration-of-infective-endocarditis-by-cardiac-ct-and-transoesophageal-echocardiography-comparison-with-intra-operative-findings
#5
Hyun Jung Koo, Dong Hyun Yang, Joon-Won Kang, Joo Yeon Lee, Dae-Hee Kim, Jong-Min Song, Duk-Hyun Kang, Jae-Kwan Song, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae-Won Lee, Tae-Hwan Lim
Aims: We aimed to compare imaging findings of infective endocarditis between computed tomography (CT) and transoesophageal echocardiography (TEE) using surgical inspection as a reference standard. Methods and results: Forty-nine patients (aged 54 ± 17 years, 69% men) who underwent pre-operative CT and TEE for infective endocarditis were included. Twelve of these patients had prosthetic valve endocarditis. Imaging findings of infective endocarditis were classified as vegetation, leaflet perforation, abscess/pseudoaneurysm, and paravalvular leakage...
February 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28329206/precise-moulded-autologous-pericardial-configurations-for-aortic-cusp-reconstruction
#6
Mohammad Bashar Izzat, Khaled Hamzeh, Farouk Almohammad
OBJECTIVES: In order to facilitate surgical repair of complex aortic cusp deformities and restoration of aortic valve competence, new moulds were developed to shape the glutaraldehyde-treated autologous pericardium into precise cusp-like configurations that can be used in aortic cusp reconstruction. METHODS: The new moulds embodied the natural geometry of single aortic cusps, and a series of moulds were made available to correspond with all potential aortic cusp sizes...
February 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28322179/usefulness-of-intracardiac-echocardiography-for-the-diagnosis-of-infective-endocarditis-following-percutaneous-pulmonary-valve-replacement
#7
Sara Bouajila, Aurélie Chalard, Claire Dauphin
Infective endocarditis is a serious complication occurring after percutaneous pulmonary valve replacement with a Melody valve; it is of uncertain incidence, and presents a challenging diagnosis. Vegetations may be difficult to visualise with transthoracic and transoesophageal echocardiography. We report the role of intracardiac echocardiography in this condition by confirming the prosthesis involvement.
March 21, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28302656/3d-transoesophageal-echocardiography-in-the-tavi-sizing-arena-should-we-do-it-and-how-do-we-do-it
#8
REVIEW
Caroline Bleakley, Mehdi Eskandari, Mark Monaghan
Transcatheter aortic valve implantation (TAVI) was initially proven as an alternative to valve replacement therapy in those beyond established risk thresholds for conventional surgery. With time the technique has been methodically refined and offered to a progressively lower risk cohort, and with this evolution has come that of the significant imaging requirements of valve implantation. This review discusses the role of transoesophageal echocardiography (TOE) in the current TAVI arena, aligning it with that of cardiac computed tomography, and outlining how TOE can be used most effectively both prior to and during TAVI in order to optimise outcomes...
March 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28274714/quantification-of-multiple-mitral-regurgitant-jets-an-in%C3%A2-vitro-validation-study-comparing-two-and-three-dimensional-proximal-isovelocity-surface-area-methods
#9
Fabian Zürcher, Nicolas Brugger, Silje Ekroll Jahren, Stefano Fausto de Marchi, Christian Seiler
BACKGROUND: The accuracy of the proximal isovelocity surface area (PISA) method for the quantification of mitral regurgitation (MR), in the case of multiple jets, is unknown. The aim of this study was to evaluate different two-dimensional (2D) and three-dimensional (3D) PISA methods using 3D color Doppler data sets. METHODS: Several regurgitant volumes (Rvols) were simulated using a pulsatile pump connected to a phantom equipped with single and double regurgitant orifices of different sizes and interspaces...
March 5, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28270398/pulmonary-vein-mass-with-extension-to-the-left-atrium-diagnosed-by-echocardiography
#10
Jezreel Labrador Taquiso, Jaime Alfonso Manalo Aherrera, Jose Donato Magno, Eric Oliver Sison
We report a case of a man aged 65 years presenting with chronic cough, haemoptysis and intermittent atrial tachyarrhythmias on ECG. On 2D transthoracic echocardiography, an incidental left atrial mass was seen, initially thought to be a thrombus predisposed by intermittent atrial fibrillation. Transoesophageal echocardiography confirmed that this left atrial mass originated from a fixed, non-homogenous, right superior pulmonary vein mass with an extracardiac extension. Because of this finding, a thorough search for a primary focus lead to the discovery of a contiguous posterior mediastinal mass, which was a round cell neoplasm on histology...
March 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28249937/is-transnasal-tee-imaging-a-viable-alternative-to-conventional-tee-during-structural-cardiac-interventions-a-comparison-of-image-quality
#11
Dimitris Klettas, Emma Alcock, Rafal Dworakowski, Philip MacCarthy, Mark Monaghan
AIM: The role of transoesophageal echocardiography in cardiac interventional structural procedures is well established and appreciated. However, the need for general anaesthesia (GA) throughout the procedure remains a controversial issue. The aim of the present study is to assess the feasibility and imaging quality of using a transnasal microrobe that allows the usage of conscious sedation in patients that undergo cardiac structural interventional procedures without missing the benefits, guidance and navigation of conventional trans-procedural TEE...
March 1, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28196823/cor-triatriatum-sinistrum-presentation-of-syncope-and-atrial-tachycardia
#12
Malcolm Avari, Sunil Nair, Zofia Kozlowska, Samer Nashef
We present a rather unusual cause for syncope associated with atrial tachycardia. A man aged 39 years presented with an episode of syncope and narrow complex tachycardia. Further investigations, including transoesophageal echocardiography, identified cor triatriatum sinistrum (CTS), a rare congenital abnormality characterised by the atrium being divided by a fibrous membrane. Although it is rare, there has been an increase in diagnosis due to developments in diagnostic imaging techniques. Symptoms are related to the size of fenestrations within the fibrous membrane...
February 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28165129/large-field-intravascular-ultrasound-for-annular-sizing-and-predicting-paravalvular-regurgitation-during-tavr-comparisons-with-multidetector-computed-tomography-and-transoesophageal-echocardiography
#13
Diaa Hakim, Gopal Ghimire, Oluseun O Alli, Satinder Singh, Mark F Sasse, Oscar J Booker, Garima Arora, Tara Leesar, Lindsey Jernigan, Spencer J Melby, James E Davies, Massoud A Leesar
No abstract text is available yet for this article.
February 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28123762/percutaneous-pfo-closure-for-cryptogenic-stroke-in-the-setting-of-a-systematic-cardiac-and-neurological-screening-and-a-standardised-follow-up-protocol
#14
Stéphane Noble, Robert F Bonvini, Fabio Rigamonti, Roman Sztajzel, Fabienne Perren, Philippe Meyer, Hajo Müller, Marco Roffi
BACKGROUND: There are no uniform workup and follow-up (FU) protocols for patients presenting with cryptogenic embolism (CE) who undergo percutaneous closure of a patent foramen ovale (PFO). METHODS: We prospectively performed a systematic cardiac and neurological FU protocol in all patients who underwent percutaneous PFO closure in order to assess the incidence of subsequent cardiac and neurological adverse events. All patients received dual antiplatelet therapy for 6 months and were systematically included in a 12-month standardised FU protocol including: clinical evaluation-transthoracic and transoesophageal echocardiography, 24-hour Holter monitoring and/or 1-week R-test, and transcranial Doppler...
2017: Open Heart
https://www.readbyqxmd.com/read/28100525/transoesophageal-echocardiographic-evaluation-of-central-venous-catheter-positioning-using-peres-formula-or-a-radiological-landmark-based-approach-a-prospective-randomized-single-centre-study
#15
J H Ahn, I S Kim, J H Yang, I G Lee, D H Seo, S P Kim
BACKGROUND: The lower superior vena cava (SVC), near its junction with the right atrium (RA), is considered the ideal location for the central venous catheter tip to ensure proper function and prevent injuries. We determined catheter insertion depth with a new formula using the sternoclavicular joint and the carina as radiological landmarks, with a 1.5 cm safety margin. The accuracy of tip positioning with the radiological landmark-based technique (R) and Peres' formula (P) was compared using transoesophageal echocardiography...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28096184/the-modern-role-of-transoesophageal-echocardiography-in-the-assessment-of-valvular-pathologies
#16
REVIEW
Malgorzata Wamil, Sacha Bull, James Newton
Despite significant advancements in the field of cardiovascular imaging, transoesophageal echocardiography remains the key imaging modality in the management of valvular pathologies. This paper provides echocardiographers with an overview of the modern role of TOE in the diagnosis and management of valvular disease. We describe how the introduction of 3D techniques has changed detection and grading of valvular pathologies and concentrate on its role as a monitoring tool in interventional cardiology. In addition, we focus on the echocardiographic and Doppler techniques used in the assessment of prosthetic valves, and provide guidance for evaluation of prosthetic valves...
January 17, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28093089/atrial-septal-defect-with-right-to-left-shunt-in-the-absence-of-pulmonary-hypertension
#17
Devi A Manuel, Gopal C Ghosh, Anoop G Alex
We describe the case of a 27-year-old gentleman who developed late-onset clubbing and cyanosis. Transoesophageal echocardiography revealed a 27-mm ostium secundum atrial septal defect and a large, floppy Eustachian valve directing right atrial blood to the left side of the heart.
January 17, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28087158/echocardiographic-approach-to-cardiac-tamponade-in-critically-ill-patients
#18
REVIEW
Peter McCanny, Frances Colreavy
Cardiac tamponade should be considered in a critically ill patient in whom the cause of haemodynamic shock is unclear. When considering tamponade, transthoracic echocardiography plays an essential role and is the initial investigation of choice. Diagnostic sensitivity of transthoracic echocardiography is dependent on image quality, and in some cases a transoesophageal approach may be required to confirm the diagnosis. Knowledge of the pathophysiology and echocardiographic features of cardiac tamponade are essential for the practicing Intensivist...
December 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28077536/cerebral-oxygen-saturation-and-cardiac-output-during-anaesthesia-in-sitting-position-for-neurosurgical-procedures-a-prospective-observational-study
#19
P Schramm, I Tzanova, F Hagen, M Berres, D Closhen, G Pestel, K Engelhard
BACKGROUND: Neurosurgical operations in the dorsal cranium often require the patient to be positioned in a sitting position. This can be associated with decreased cardiac output and cerebral hypoperfusion, and possibly, inadequate cerebral oxygenation. In the present study, cerebral oxygen saturation was measured during neurosurgery in the sitting position and correlated with cardiac output. METHODS: Perioperative cerebral oxygen saturation was measured continuously with two different monitors, INVOS(®) and FORE-SIGHT(®)...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077535/the-impact-of-a-perceptual-and-adaptive-learning-module-on-transoesophageal-echocardiography-interpretation-by-anaesthesiology-residents
#20
B T Romito, S Krasne, P J Kellman, A Dhillon
BACKGROUND: The role of transoesophageal echocardiography (TOE) in anaesthetic practice is expanding. We evaluated the effect of a TOE perceptual and adaptive learning module (PALM) on first-yr anaesthesiology residents' performance, in diagnosing cardiac pathology by TOE. METHODS: First-yr residents were assigned to a group (n = 12) that used a TOE PALM or a control group that did not (n = 12). Both groups received a TOE pretest that measured their accuracy and response times...
October 2016: British Journal of Anaesthesia
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