Role of Echocardiography for Immediate Postoperative ICU Management after Tetralogy of Fallot Repair
[Year:2018] [Month:July-December] [Volume:6] [Number:2] [Pages:3] [Pages No:33 - 35]
DOI: 10.5005/jp-journals-10034-1085 | Open Access | How to cite |
ALCAPA and Tetralogy of Fallots: A Rare Echocardiographic Combination
[Year:2018] [Month:July-December] [Volume:6] [Number:2] [Pages:4] [Pages No:36 - 39]
Keywords: Anomalous origin of the left coronary artery from the pulmonary artery, Tetralogy of Fallots, transesophageal echocardiography
DOI: 10.5005/jp-journals-10034-1086 | Open Access | How to cite |
Abstract
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an uncommon congenital anomaly. We report a rare association of ALCAPA with tetralogy of Fallots (TOF). The physiology, clinical presentation and specific echocardiographic clues that suggest diagnosis in these circumstances can be different from a patient having isolated ALCAPA. In such clinical scenario, the anesthesiologist should able to recognize the echocardiographic features of the coexistence of ALCAPA and be aware of the potential pitfalls.
Caseous Calcification in the Mitral Annulus: An Unusual Presentation in a Young Patient
[Year:2018] [Month:July-December] [Volume:6] [Number:2] [Pages:4] [Pages No:40 - 43]
Keywords: Caseous calcification, Echocardiography, Mitral annulus calcification, Rheumatic heart disease
DOI: 10.5005/jp-journals-10034-1087 | Open Access | How to cite |
Abstract
Calcification of the mitral valve annulus is a chronic degenerative process commonly seen in the older age group. In developing countries like India, it can occur in later stages of rheumatic heart disease. Caseous calcification (CC) of the mitral annulus is a less described atypical variant of mitral valve calcification commonly reported in the basal area of the posterior mitral leaflet in elderly patients with degenerative diseases. The peculiarity of our case is the early age of development, i.e., CC had developed in a 15-year-old male patient with rheumatic heart disease diagnosed by echocardiography and helped in further management.
[Year:2018] [Month:July-December] [Volume:6] [Number:2] [Pages:4] [Pages No:44 - 47]
Keywords: Rheumatic heart disease, Subaortic membrane, Transesophageal echocardiography
DOI: 10.5005/jp-journals-10034-1088 | Open Access | How to cite |
Abstract
Subaortic membrane (SAM), a rare lesion in the adult population is suspected when there is a high-velocity gradient across the aortic valve with normal functioning aortic valve. With rheumatic heart disease forming the leading cause of valvular pathology in the Indian population, SAM can be missed in adult patients with poor transthoracic echocardiography window and can be misinterpreted as rheumatic heart disease. We report a case of SAM causing aortic valve pathology leading to aortic stenosis and regurgitation which was diagnosed accurately using 2D and 3D transesophageal echocardiography during the intraoperative period.
Volume Assessment in Interrupted Inferior Vena Cava
[Year:2018] [Month:July-December] [Volume:6] [Number:2] [Pages:3] [Pages No:48 - 50]
Keywords: Congenital abnormalities, Diagnostic imaging, Inferior vena cava
DOI: 10.5005/jp-journals-10034-1089 | Open Access | How to cite |
Abstract
Bedside ultrasound imaging of inferior vena cava (IVC) is commonly used to guide fluid administration. Here, we present the echocardiography and angiography images of a post-operative surgical patient in whom an anomalous IVC was detected during evaluation for hemodynamic instability
Experience with Tetralogy of Fallot Patients in a Tertiary Care Teaching Institute of North India
[Year:2018] [Month:July-December] [Volume:6] [Number:2] [Pages:6] [Pages No:51 - 56]
Keywords: Echocardiography, Innominate vein, Tetralogy of fallot
DOI: 10.5005/jp-journals-10034-1090 | Open Access | How to cite |
Abstract
Tetralogy of fallot (TOF) is the most common cyanotic congenital heart disease. Anatomical variations occurring in these patients often contribute to postoperative morbidity and affect the long term outcome. However, there is limited literature discussing the perioperative imaging and management of these variations. In this review, we highlight the common anatomical variations we encountered at our institute during routine perioperative echocardiography. Discussion of these with the operating team helped us in improving the surgical outcome.
[Year:2018] [Month:July-December] [Volume:6] [Number:2] [Pages:3] [Pages No:57 - 59]
Keywords: Eustachian valve, Dual stage Cavo-atrial cannula, Transesophageal echocardiography
DOI: 10.5005/jp-journals-10034-1091 | Open Access | How to cite |
Abstract
Eustachian valve is an embryonic remnant of the right valve of sinus venosus. In adults it may be completely absent or may appear as a thin flap. However, in some cases it may persist as a long mobile structure which can be mistaken as patent foramen ovale or cor-triatrium dexter. Sometimes it can obstruct the single stage cavo-atrial cannula while inserting into inferior vena cava (IVC). We hereby discuss a technique which helped in the successful cannulation of the dual stage cavo-atrial cannula into the IVC in a patient with a giant eustachian valve with the help of transesophageal echocardiography (TEE).
[Year:2018] [Month:July-December] [Volume:6] [Number:2] [Pages:4] [Pages No:60 - 63]
Keywords: Cardiac extension, Transesophageal echocardiography, Uterine leiomyoma
DOI: 10.5005/jp-journals-10034-1092 | Open Access | How to cite |
Abstract
Uterine leiomyoma is a common benign tumor that arises from the overgrowth of smooth muscle and connective tissue in the uterus. Transesophageal echocardiography is a very useful diagnostic modality in the intraoperative period as it provides us real time imaging. We report a case of uterine leiomyoma with intracaval and right atrial extension that TEE was helpful in the intraoperative management.
Close proximity of the left coronary ostium with the MPA
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Upper esophageal short axis aortic arch view showing MPA with ostium of LCA distal to the pulmonary valve
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Color Doppler revealed retrograde flow from the ostium of LCA (blue color)
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The TEE imaging in the post-CPB period showed unobstructed flow in the translocated LCA with no evidence of any regional wall abnormality
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Parasternal long axis view in transthoracic echocardiography showing a severe mitral regurgitation and an echo-dense mass located at the posterior mitral annulus. LA, left atrium; LV, left ventricl...
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Caseous calcification of posterior mitral annulus (parasternal aortic valve long axis view): Large echo-dense mass with smooth borders near posterior mitral annulus at the junction between left atr...
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Parasternal left ventricular basal short axis view showing a round, echo dense mass with smooth surface near posterior annulus of mitral valve. LV, left ventricle. RV, right ventricle
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Mid esophageal aortic valve long axis view in transesophageal echocardiography showing (A) a large round echo-dense mass near posterior mitral valve, (B) mitral stenosis and aortic regurgitation. A...
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Mid-esophageal aortic valve long axis view (Zoomed) showing thickened ridge of tissue at the under-surface of the right coronary cusp and also at the base of the anterior mitral valve leaflet. RCC,...
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Mid-esophageal long axis view (3D - Aortic valve zoomed) showing membrane attached to the under-surface of the right coronary cusp and also at the base of the anterior mitral leaflet. RCC, Right co...
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Parasternal right ventricle inflow outflow view in a tetralogy of Fallot patient with sub-arterial ventricular septal defect. Note the sub-arterial ventricular septal defect, which is away from the...
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Midesophageal right ventricle inflow outflow view in a tetralogy of Fallot patient with restrictive ventricular septal defect. Note the ventricular septal defect being closed by the septal tricuspi...
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Upper oesophageal aortic arch short axis view in a tetralogy of Fallot patient with pulmonary valvular stenosis. Note the ability to visualize the doming pulmonary valve in the near field of echo a...
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Transgastric right ventricle outflow view in a patient with repaired tetralogy of Fallot with a monocuspid neo-pulmonary valve. PV, Neo-pulmonary valve; RV, Right ventricle.
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Upper oesophageal aortic arch short axis view in a patient with repaired tetralogy of Fallot with monocuspid neo-pulmonary valve. MPA, Main pulmonary artery; PV, Neo-pulmonary valve
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Upper left parasternal view during apnea showing the pulmonary artery bifurcation and a good view of the left pulmonary artery. LPA, Left pulmonary artery; MPA, Main pulmonary artery
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Mid-esophageal view in a tetralogy of Fallot patient demonstrating the blood flow from a large patent ductus arteriosus into the main pulmonary artery.*- Blood flow into the main pulmonary artery f...
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Retroaortic innominate vein in a patient with tetralogy of Fallot. Note the innominate vein located behind the ascending aorta, adjacent to the right pulmonary artery. IV, Innominate vein; LVOT, Le...
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Dilated coronary sinus in a tetralogy of Fallot patient who was detected to have a persistent left superior vena cava. (A) Midesophageal two chamber view, (B) Coronary sinus visualised by slightly ...
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Descending aorta located anterior to the esophagus in a tetralogy of Fallot patient with right sided aortic arch, with the probe placed in the lower esophageal position to visualize the inferior ve...
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Descending thoracic aorta giving rise to a vessel which was later confirmed to be a major aortopulmonary collateral artery. DTA, Descending thoracic aorta. *, Major aortopulmonary collateral artery
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Parasternal long axis view in a tetralogy of Fallot patient with a small left ventricle and posted for shunt procedure. LA, Left atrium; LV, Left ventricle; RV, Right ventricle.
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Mid-esophgeal right ventricle inflow outflow view showing residual obstruction below the infundibular patch in a repaired tetralogy of fallot patient. RV, Right ventricle; RVOT, Right ventricle ouf...
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Transgastric right ventricle outflow view showing double chamber right ventricle in a tetralogy of Fallot patient presenting after 1 year after repair. *, Muscle bundle in right ventricle outflow t...
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Dynamic outflow obstruction persisting after surgical relief of right ventricle outflow obstruction in a neonate. (A) Systolic frame of midesophageal right ventricle outflow demonstrating diffuse h...
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A mid-esophageal bicaval view showing a gaint 2.3cm eustachian valve. It was misinterpreted as a part of interatrial septum and misdiagnosis of patent foramen ovale (green arrow) was made. LA, left...
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Mid-esophageal modified bicaval view at 71° rotation showing a eustachian valve obstructing the insertion of dual stage cavoatrial cannula into inferior vena cava. LA, left atrium; RA, right atrium.
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Mid-esophageal bicaval view showing a dual stage cavoatrial cannula directed towards interatrial septum and then advanced into the inferior vena cava. LA, left atrium; RA, right atrium.
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Subxiphoid window, sagittal plane in the index patient showing collapsed vessel(*) in place of inferior vena cava
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Subxiphoid window, transverse plane in the index patient showing the absence of any vessel at the usual location of Inferior vena cava, adjacent to the aorta
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Angiography image of contrast injected through a catheter inserted via a femoral vein into the superior vena cava. Note the pathway of contrast away from that of the catheter
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