MitraClip is a percutaneous edge-to-edge mitral repair device approved for degenerative and functional mitral regurgitation (MR). Regurgitant jets are localized using transesophageal echocardiography, and the clip is guided such that it grasps the anterior and posterior mitral leaflets at the origin of the regurgitant jet. This is sometimes trickier than…
Whenever my residents/fellows or I place central venous catheters (CVCs) in the operating room for a case involving intraoperative transesophageal echocardiography (TEE), I always place the TEE probe beforehand. I obtain a midesophageal bicaval view looking for preexisting hardware in the patient’s right atrium (RA), such as ICD wires, PICC…
The mitral valve’s complex geometry is usually described as a “saddle shape”, but I definitely prefer the comparison to Pringles chips! Here’s an illustration showing the relevant mitral anatomy. No Pringles were harmed in this production. :-)
Early in my training as a medical student and intern, it seemed that all people ever cared about on an echo report was the “EF!” This refers to the left ventricular ejection fraction (LVEF) – the percentage of the left ventricle’s diastolic blood volume that is pumped out after a…
The hepatorenal recess (“Morison’s pouch”) is a potential space between the liver and the right kidney. With small volumes of intra-abdominal blood (hemoperitoneum), ascites, or even peritoneal dialysis, fluid accumulates in this recess, which shows up as a near-black stripe on ultrasound. This video shows Morison’s pouch containing no discernible…
After returning from the Society of Cardiovascular Anesthesiologists annual meeting in Chicago last week, I received my Butterfly iQ and have been using it over the last week!
A bubble study is often utilized to confirm the presence of shunting across the interatrial septum (IAS) via patent foramen ovale (PFO) or atrial septal defect (ASD). This study combines color flow Doppler and 2D inspection of the IAS anatomy to determine if a defect indeed exists. A Valsalva maneuver…
My ICU colleagues and I walked into yesterday’s first-ever administered critical care ultrasound certification examination without much insight about the exam itself except for a very generic content outline. Here are my reflection/impressions of the test.
My critical care ultrasound exam is scheduled for tomorrow. This is the first time this exam has been offered, so there is no established consensus on how to prepare for it. That being said, I’ve reviewed relevant chapters from Perrino’s A Practical Approach to Transesophageal Echocardiography and consulted Society of…
As part of my cardiothoracic anesthesia fellowship, we are required to submit an abstract to present at the Society of Cardiovascular Anesthesiologists annual meeting. This will be in May 2019 in Chicago!