Novel Use of Transesophageal Echocardiographic Probe for Intraoperative Epicardial Imaging Adrian Ionescu, MD, FRCP, Michael Gilbert, MD, FRCA, Pankaj.

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Presentation transcript:

Novel Use of Transesophageal Echocardiographic Probe for Intraoperative Epicardial Imaging Adrian Ionescu, MD, FRCP, Michael Gilbert, MD, FRCA, Pankaj Kumar, MD, FRCS The Annals of Thoracic Surgery Volume 91, Issue 3, Pages 914-917 (March 2011) DOI: 10.1016/j.athoracsur.2010.07.006 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Typical set-up for “epicardial transesophageal echocardiography.” The probe, covered in a sterile sheath, is inserted by the surgeon through the sternotomy so that the imaging element at the tip of the probe is apposed on the anterior surface of the left ventricle. Note the echocardiographic scanner in the background. The Annals of Thoracic Surgery 2011 91, 914-917DOI: (10.1016/j.athoracsur.2010.07.006) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Apical long-axis view by transesophageal echocardiography, allowing clear visualization of the apex of the left ventricle in a patient with a repaired post-infarct ventricular septal defect. Note edge of patch (arrow). The Annals of Thoracic Surgery 2011 91, 914-917DOI: (10.1016/j.athoracsur.2010.07.006) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Epicardial transesophageal echocardiography of the left ventricle after ventricular remodelling. Note the rounded apex (arrow). The papillary muscles are imaged tangentially and produce a “pseudo-mass” effect. The Annals of Thoracic Surgery 2011 91, 914-917DOI: (10.1016/j.athoracsur.2010.07.006) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Transesophageal echocardiography images after mitral valve repair, which are not able to be interpreted. Hyperinflated lungs interposed between the esophagus and the heart produce severe attenuation of the ultrasound beam. The Annals of Thoracic Surgery 2011 91, 914-917DOI: (10.1016/j.athoracsur.2010.07.006) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Epicardial transesophageal echocardiography showing a clear diastolic image of the flow through the mitral valve with excellent endocardial definition and good quality of the color flow map; in the same patient shown in Figure 4. The Annals of Thoracic Surgery 2011 91, 914-917DOI: (10.1016/j.athoracsur.2010.07.006) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions