Apical four chamber view to assess valve position and perivalvular leak by transthoracic echocardiography

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 110-110
Author(s):  
Jiapeng Huang ◽  
Sheng Wang ◽  
Jiakai Lu
Keyword(s):  
Transthoracic Echocardiography ◽  
Chamber View ◽  
Valve Position

scholarly journals P025: Optimizing practice for learning emergency department transthoracic echocardiography using an ultrasound simulator

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S86-S87
Author(s):  
D.D. Cho ◽  
J. Chenkin
Keyword(s):  
Emergency Department ◽  
Transthoracic Echocardiography ◽  
Orthogonal Design ◽  
Difficulty Level ◽  
Attractive Alternative ◽  
Practice Group ◽  
Chamber View ◽  
Technology Educators ◽  
Group B ◽  
Ultrasound Simulator

Introduction: Emergency department (ED) transthoracic echocardiography (TTE) is an important application of emergency department bedside ultrasound. Given limited curricular hours and economic constraints, training using ultrasound simulators represents an attractive alternative to using live-human models. Despite increased uptake of ultrasound simulator technology, educators lack evidence informing how best to use this technology. Three educational paradigms will be explored in this study: self-guided theory (learners are able to determine when they have had “enough practice”), desirable difficulties (manipulating practice conditions to create more durable and flexible learning), and the challenge point framework (avoiding cognitive overload). The question we seek to answer is: in novice medical trainees, which practice condition leads to improved learning in a test of retention when assessing the ability to generate and interpret a parasternal long axis (PLAX) and apical four-chamber view (A4CH) of the heart? Methods: Ultrasound-novices will be recruited from rotators in the ED. Participants will be allocated to one of three groups based on a 2x2 orthogonal design: Group A (variable difficulty × self-determined practice); Group B (variable difficulty × fixed practice); Group C (static difficulty × fixed practice). A standardized didactic lecture will be presented to each participant. Practice conditions with respect to difficulty level (easy, medium, hard) and structure of practice (learner-determined or fixed practice) will vary according to assigned groups. All groups will receive standardized feedback. The ability to identify anatomy and pathology will be assessed. At the conclusion of practice, a post-practice skills assessment and survey will be administered. Two to three weeks later, participants will be retested using three case scenarios. Screenshots of the participant-determined “best image” and video of the performance will be taken to be evaluated by two blinded (to group allocation) reviewers. Results: We have currently enrolled 14 participants. We aim to complete enrollment by April 2016. Conclusion: We anticipate that our study will provide evidence to inform the best use of ultrasound simulators for teaching TTE in the ED. It will also provide insight into the ability of three educational theories to predict best learning using a novel educational intervention.

scholarly journals Case Report: Assessing the Position of Pacemaker Leads via Transthoracic Echocardiography: Additional Value of the Subcostal En Face View

2021 ◽  
Vol 8 ◽  
Author(s):  
Andrea Simone Deichl ◽  
Philipp Lacour ◽  
Evgeny Belyavskiy ◽  
Burkert Pieske ◽  
Elisabeth Pieske-Kraigher ◽  
...  
Keyword(s):  
Transthoracic Echocardiography ◽  
Case Series ◽  
Direct Interaction ◽  
Subsequent Development ◽  
Cardiac Implantable Electronic Devices ◽  
Chamber View ◽  
En Face ◽  
Pacemaker Leads ◽  
Face View ◽  
Additional Value

There is an association between presence of cardiac implantable electronic devices (CIED) and development of tricuspid regurgitation (TR). Mechanisms proposed to explain CIED-induced TR can be classified as implantation-related, lead-related, and pacing-related. Lead-related TR results from the direct interaction of the lead with the tricuspid valve (TV). The localization of the lead at the TV level directly influences the probability of subsequent development of significant TR. A transthoracic subcostal en face view of the TV can be acquired in most patients through a 90° rotation from the subcostal 4-chamber view with clear anatomic delineation of the TV and the commissures including lead position. This case-series presents three examples where the transthoracic en face view could add incremental information on the position of the pacemaker leads and on the mechanism of TR.Conclusion: When performing transthoracic echocardiography in patients with trans-tricuspid CIED lead(s), an en face view of the TV with exact reporting of the position of the lead(s) should be included.

Comparison of right ventricular volumes by transthoracic and transesophageal echocardiography in patients with right ventricular volume overload

1997 ◽  
Vol 7 (4) ◽  
pp. 417-422 ◽  
Author(s):  
Andreas Gamillscheg ◽  
Zhen Jin ◽  
Jonathan Skinner ◽  
Ingram Schulze-Neick ◽  
Jan-Hendrik Nürnberg ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Atrial Septal Defect ◽  
Transesophageal Echocardiography ◽  
Body Surface ◽  
Transthoracic Echocardiography ◽  
Septal Defect ◽  
Ventricular Volume ◽  
Right Ventricular Volume ◽  
Ventricular Volumes ◽  
Chamber View

AbstractAssessment of right ventricular volume and function is important in most congenital heart diseases before and after corrective or palliative surgery. Since transthoracic echocardiography is often substituted by transesophageal echocardiography in the perioperative setting, it is useful to compare transesophageal echocardiography with transthoracic echocardiography as performed preoperatively. We compared right ventricular volumes as calculated using these two methods from a four-chamber view in 21 children and adults with atrial septal defect. For right ventricular end-diastolic volumes of less than 70 ml, and end-systolic volumes of less than 40 ml, a close correlation was found between the techniques (r=0.99 and r=0.91, respectively), with a small degree of underestimation by transesophageal echocardio­graphy. For values larger than 70 nil and 40 ml, respectively, correlation decreased (r=0.41 for end-diastolic volumes and r=0.48 for end-systolic volumes) and underestimation of volume by transesophageal echocardiography increased. Underestimation of right ventricular end-diastolic volumes increased with increasing body surface area (r=0.74), and with progressive right ventricular enlargement (r=0.63). In patients with a body surface area of more than 1m2, the largest end-diastolic right ventricular length determined by transthoracic echocardiography was significantly longer than that derived by transesophageal echocardiography (p<0.001), whereas in smaller patients there was no significant difference between the two methods (p>0.1). If right ventricular volumes determined by transthoracic echocardiography using a four-chamber view are substituted by those obtained with transesophageal echocardiography in serial haemodynamic evaluation of patients with atrial septal defect, different correlation equations and, consequently, a different degree of underestimation by transesophageal echocardiography must be considered for large and small volumes. This increasing underestimation of larger right ventricular volumes seems to be based on foreshortening of the long cross-sectional axis of the right ventricle as seen in the transesophageal four-chamber view.

METHODOLOGICAL ASPECTS OF VISUALIZATION OF CORONARY ARTERIES WITH TRANSTHORACIC ECHOCARDIOGRAPHY

2018 ◽  
pp. 26-35
Author(s):  
Z. A. Agaeva ◽  
K. B. Baghdasaryan
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Coronary Arteries ◽  
Transthoracic Echocardiography ◽  
Second Harmonic ◽  
Anatomic Reconstruction ◽  
High Quality ◽  
Acoustic Window ◽  
Methodological Aspects

The transthoracic echocardiography made by multifrequency probes with support of the mode of the second harmonic imaging, is a competitive method for visualization of the main coronary arteries and allows to estimate coronary blood flow with high quality. Of course, the method has considerable restrictions, most important of which is the low spatial resolution of a method, due to small acoustic window. Because of this the transthoracic visualization of coronary arteries perhaps will not become the leading method of anatomic reconstruction of separately taken coronary artery and especially all coronary arteries system. However uniqueness and indisputable advantage of this method is an opportunity to noninvasively estimate a coronary blood flow both once, and in dynamics.

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