Journal of Perioperative Echocardiography

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Volume 8, Number 1, January-June 2020
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EDITORIAL

Minati Choudhury

Left Atrial Strain: Is it a Paragon, Which We Cardiac Anesthesiologists Misconstrue?

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:2] [Pages No:1 - 2]

   DOI: 10.5005/jp-journals-10034-1115  |  Open Access |  How to cite  | 

228

CASE REPORT

Sunder Lal Negi, Subhrashis G Niyogi, Sonam Norbu, Vikas Kumar, Sheenam Walia

A Rare Case of Prolapsing Accessory Tricuspid Valve Tissue into the Ventricular Septal Defect in Patient Undergoing Tetralogy of Fallot Repair: Role of Transesophageal Echocardiography

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:3] [Pages No:3 - 5]

Keywords: Accessory tricuspid valve tissue, Tetralogy of Fallot, Transesophageal echocardiography

   DOI: 10.5005/jp-journals-10034-1109  |  Open Access |  How to cite  | 

Abstract

Accessory tricuspid valve tissue (ATV) is a rare congenital cardiac malformation most commonly associated with congenital cardiac anomalies. In literature, reported cases are associated with occlusion of the ventricular septal defect (VSD) by ATV. Therefore, accurate diagnosis of ATV in patients undergoing cardiac surgery is important. We report a rare case of ATV tissue in a patient undergoing tetralogy of Fallot (TOF) repair. Introduction: Accessory tricuspid valve tissue is a rare congenital cardiac anomaly most commonly associated with congenital cardiac anomalies with varying clinical and hemodynamic features. Most of the reported cases were associated with various other intracardiac anomalies, such as TOF, transposition of a great artery, and VSD. When associated with VSDs, it can cause partial to near-complete obstruction of the VSD or it can cause right ventricular outflow tract (RVOT) obstruction. Therefore, preprocedure diagnosis and confirmation are needed when it is associated with congenital cardiac abnormalities.

163

CASE REPORT

Krishna P Gourav, Sunder Lal Negi, Indranil Biswas, Subhrashis G Niyogi, Goverdhan Dutt Puri, Kulbhushan Saini

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:6] [Pages No:6 - 11]

Keywords: COVID-19, Chest X-ray, Point-of-care echocardiography

   DOI: 10.5005/jp-journals-10034-1110  |  Open Access |  How to cite  | 

Abstract

Personal protective measures make traditional clinical examination difficult in the context of the novel coronavirus-2019 (COVID-19) pandemic. Point-of-care ultrasound and echocardiography may ably complement clinical examination and allow optimal management of COVID-19 as well as coexisting comorbidities. Here, the authors describe a series of cases illustrating the same and discuss how point-of-care echocardiography can be expediently and safely implemented.

138

CASE REPORT

Avneet Singh, Rajarajan Ganesan, Harkant Singh, Tsering Sandup, Subhrashis G Niyogi, Nischitha Gowda

Three-dimensional Echocardiographic Evaluation of Infective Endocarditis Aortic Valve Pathology in a COVID-19 Recovered Patient

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:3] [Pages No:12 - 14]

Keywords: Aortic valve replacement, Infective endocarditis, Transesophageal echocardiography

   DOI: 10.5005/jp-journals-10034-1111  |  Open Access |  How to cite  | 

Abstract

The incidence of nosocomial infective endocarditis (IE) has increased in the last 2 years during the COVID-19 pandemic and the patients might present with overlapping symptoms of heart failure and pneumonia. Simultaneously, COVID-19 is a hypercoagulable disorder that can complicate the postoperative course of a patient undergoing valve replacement. Therefore, the exact pathology of the native valve needs to be evaluated in such patients. We describe a case of a 45-year-old man with a history of non-compressive myelopathy and COVID-19 infection scheduled for aortic valve replacement and subaortic membrane resection. Intraoperative transesophageal echocardiography was instrumental in defining the aortic valve anatomy that changed the management plan.

180

CASE REPORT

Subhrashis Guha Niyogi, Avneet Singh, Nischitha Gowda, Rajarajan Ganesan, Sunder L Negi, Harkant Singh

Transvalvular Regurgitation across a Tilting Disk Prosthetic Mitral Valve: Role of Intraoperative Real-time Three-dimensional Transesophageal Echocardiography

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:3] [Pages No:15 - 17]

Keywords: 3D echocardiography, Chitra heart valve prosthesis, Prosthetic valve dysfunction

   DOI: 10.5005/jp-journals-10034-1112  |  Open Access |  How to cite  | 

Abstract

Prosthetic valve regurgitation in the immediate post-implantation period can be caused by paravalvular or transvalvular leakage. Close examination with two-dimensional (2D) as well as three-dimensional (3D) transesophageal echocardiography (TEE) is necessary for its proper diagnosis. A case of transvalvular regurgitation across a tilting disk prosthetic valve in mitral position is described here, along with the role of 3D TEE in its diagnosis. Image acquisition and optimization for 3D TEE in prosthetic valve evaluation is also briefly reviewed.

175

CASE REPORT

Thanigai Arasu, Sunder Lal Negi, Goverdhan Dutt Puri

Pneumomediastinum and Pneumopericardium: Impediment to the Transthoracic Echo Windows

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:3] [Pages No:18 - 20]

Keywords: Cardiac A-lines, COVID-19, Pneumomediastinum, Pneumopericardium

   DOI: 10.5005/jp-journals-10034-1113  |  Open Access |  How to cite  | 

Abstract

Aim and objective: To highlight the impediments for the transthoracic echo windows. Background: Pneumomediastinum and pneumopericardium with cardiac A-lines obscuring the transthoracic echo windows. Case description: A 57-year-old male patient with COVID-19 infection underwent tracheostomy and positive pressure ventilation following which he developed pneumomediastinum/pneumopericardium. Subsequently, the apical and parasternal cardiac windows replaced by A-lines hindering the echocardiographic examination. Conclusion: The disappearance of the previously available echo window should raise the suspicion of new-onset pneumomediastinum or pneumopericardium.

152

Photo Assay

Krishna P Gourav, Javid Raja, Sunder L Negi, Revanth Reddy

Giant Left Ventricular Apical Pseudoaneurysm

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:2] [Pages No:21 - 22]

Keywords: Giant apical pseudoaneurysm, Pseudoaneurysm, Transthoracic echocardiography

   DOI: 10.5005/jp-journals-10034-1114  |  Open Access |  How to cite  | 

Abstract

Massive myocardial infarction can lead to left ventricular free wall rupture (LVFWR). Sometimes it can be contained by a pericardium leading to the formation of the pseudoaneurysm. In view of the high tendency to expand and rupture an urgent surgery is indicated. We experienced a rare case of giant left ventricular apical pseudoaneurysm which was successfully managed with surgical intervention.

167

journal videos

A parasternal long axis view showing a thickened aortic valve with dilated ascending aorta.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

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A parasternal long axis view showing a moderate pericardial and pleural effusion.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

Size: 1 MB

A mid-papillary short axis view showing a normal left ventricular contractility with moderate pericardial effusion.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

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Lung ultrasound showing a right sided massive pleural effusion with underlying collapsed lung.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

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Lung ultrasound showing left sided moderate pleural effusion with underlying collapsed lung.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

Size: 1 MB

A mid-papillary short axis view showing a good contractility and low left ventricular end diastolic volume—the ‘kissing papillary sign’ of hypovolemia.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

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Sub-costal view showing a small and collapsible inferior vena cava with quiet respiration.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

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Cross sectional view of the internal jugular vein showing collapsibility with quiet respiration.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

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A mid-papillary short axis view demonstrating a regional wall motion abnormality in anteroseptal area.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

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A color flow Doppler placed in parasternal long axis view right ventricular inflow view demonstrating a moderate tricuspid regurgitation.

Point-of-care Echocardiography in Critically Ill COVID-19 Infected Patients: Will it Change the Management?

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Intraoperative transesophageal echocardiography with an up and down sweep of the left ventricle outflow tract showing flail aortic valve segment of the left coronary cusp without sub aortic membrane

Three-dimensional Echocardiographic Evaluation of Infective Endocarditis Aortic Valve Pathology in a COVID-19 Recovered Patient

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Intraoperative 3-dimensional transesophageal echocardiography examination showing flail left coronary cusp in mid-esophageal aortic valve long axis view

Three-dimensional Echocardiographic Evaluation of Infective Endocarditis Aortic Valve Pathology in a COVID-19 Recovered Patient

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Post-operative transesophageal echocardiography showing normally coapting neo-cusp with residual trivial aortic insufficiency in mid- esophageal aortic valve long axis view

Three-dimensional Echocardiographic Evaluation of Infective Endocarditis Aortic Valve Pathology in a COVID-19 Recovered Patient

Size: 468 KB

Post-operative transesophageal echocardiography showing normally coapting neo-cusp with residual trivial aortic insufficiency in mid- esophageal aortic valve short axis view

Three-dimensional Echocardiographic Evaluation of Infective Endocarditis Aortic Valve Pathology in a COVID-19 Recovered Patient

Size: 432 KB

Intraoperative trans-esophageal mid-esophageal two chamber (A) and long axis (B) views showing a tilting disk mechanical prosthetic valve in mitral position with a regurgitant jet originating inside the sewing ring.

Transvalvular Regurgitation across a Tilting Disk Prosthetic Mitral Valve: Role of Intraoperative Real-time Threedimensional Transesophageal Echocardiography

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Intraoperative trans-esophageal 3D ‘surgeon’s view’ with color Doppler demonstrating a pansystolic regurgitant jet in the posterior aspect after implantation of a tilting disk prosthetic heart valve.

Transvalvular Regurgitation across a Tilting Disk Prosthetic Mitral Valve: Role of Intraoperative Real-time Threedimensional Transesophageal Echocardiography

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Apical four chamber view showing an apical pseudoaneurysm with narrow neck.

Giant Left Ventricular Apical Pseudoaneurysm

Size: 363 KB

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