Pub Date : 2018-09-01DOI: 10.1093/med/9780198759089.003.0002
D. Sidebotham, A. Merry, M. Legget, Gavin Wright
In Chapter 2, the factors that influence image quality are reviewed. The first part of the chapter deals with the determinants of spatial and temporal resolution, particularly with respect to 2D and 3D imaging. Next, instrument controls for different ultrasound imaging modes are discussed. Here the emphasis is on adjusting the machine settings to optimize image quality, and recognizing and avoiding aliasing with PW Doppler imaging. Finally, common artefacts that may lead to misdiagnosis are discussed.
{"title":"Resolution, instrument controls, and artefacts","authors":"D. Sidebotham, A. Merry, M. Legget, Gavin Wright","doi":"10.1093/med/9780198759089.003.0002","DOIUrl":"https://doi.org/10.1093/med/9780198759089.003.0002","url":null,"abstract":"In Chapter 2, the factors that influence image quality are reviewed. The first part of the chapter deals with the determinants of spatial and temporal resolution, particularly with respect to 2D and 3D imaging. Next, instrument controls for different ultrasound imaging modes are discussed. Here the emphasis is on adjusting the machine settings to optimize image quality, and recognizing and avoiding aliasing with PW Doppler imaging. Finally, common artefacts that may lead to misdiagnosis are discussed.","PeriodicalId":153040,"journal":{"name":"Practical Perioperative Transoesophageal Echocardiography","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125108766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1093/med/9780198759089.003.0018
D. Sidebotham, A. Merry, M. Legget, Gavin Wright
In Chapter 18, the common congenital cardiac lesions encountered in adult cardiac surgical practice are reviewed. The focus of the chapter is VSDs, ASDs (and patent foramen ovale), and tetralogy of Fallot (TOF), including reoperation for PV conduit replacement in patients who have undergone repair of TOF in childhood. The different subtypes of VSD and ASD are reviewed, along with their important associations (e.g. pulmonary venous abnormalities in patients with sinus venosus ASD). Complex cardiac abnormalities, such as the Fontan circulation and operation for transposition of the great arteries, are discussed only briefly. Congenital abnormalities of the AV (e.g. bicuspid valve) are discussed in Chapter 10: The aortic valve and left ventricular outflow tract, and persistent left-sided SVC is discussed in Chapter 5: Anatomical variants and cardiac masses.
{"title":"Adult congenital heart disease","authors":"D. Sidebotham, A. Merry, M. Legget, Gavin Wright","doi":"10.1093/med/9780198759089.003.0018","DOIUrl":"https://doi.org/10.1093/med/9780198759089.003.0018","url":null,"abstract":"In Chapter 18, the common congenital cardiac lesions encountered in adult cardiac surgical practice are reviewed. The focus of the chapter is VSDs, ASDs (and patent foramen ovale), and tetralogy of Fallot (TOF), including reoperation for PV conduit replacement in patients who have undergone repair of TOF in childhood. The different subtypes of VSD and ASD are reviewed, along with their important associations (e.g. pulmonary venous abnormalities in patients with sinus venosus ASD). Complex cardiac abnormalities, such as the Fontan circulation and operation for transposition of the great arteries, are discussed only briefly. Congenital abnormalities of the AV (e.g. bicuspid valve) are discussed in Chapter 10: The aortic valve and left ventricular outflow tract, and persistent left-sided SVC is discussed in Chapter 5: Anatomical variants and cardiac masses.","PeriodicalId":153040,"journal":{"name":"Practical Perioperative Transoesophageal Echocardiography","volume":"478 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129455277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1093/med/9780198759089.003.0021
D. Sidebotham, A. Merry, M. Legget, Gavin Wright
Chapter 21 brings together many topics that are covered in earlier chapters, notably Chapter 3: Quantitative echocardiography. The chapter is divided into two sections. In the first section, methods for assessing the haemodynamic state are covered, including the measurement of stroke volume, cardiac output, LA pressure, pulmonary artery pressure, preload, and volume responsiveness. The focus of this section is on techniques that are directly applicable to TOE in mechanically ventilated patients. In the second section, the causes of haemodynamic instability are reviewed. Topics include hypovolaemia, low LV afterload, LV systolic dysfunction, LV diastolic dysfunction, RV systolic dysfunction, and cardiac tamponade. An integrated approach to the difficult diagnosis is also provided.
{"title":"Haemodynamic instability","authors":"D. Sidebotham, A. Merry, M. Legget, Gavin Wright","doi":"10.1093/med/9780198759089.003.0021","DOIUrl":"https://doi.org/10.1093/med/9780198759089.003.0021","url":null,"abstract":"Chapter 21 brings together many topics that are covered in earlier chapters, notably Chapter 3: Quantitative echocardiography. The chapter is divided into two sections. In the first section, methods for assessing the haemodynamic state are covered, including the measurement of stroke volume, cardiac output, LA pressure, pulmonary artery pressure, preload, and volume responsiveness. The focus of this section is on techniques that are directly applicable to TOE in mechanically ventilated patients. In the second section, the causes of haemodynamic instability are reviewed. Topics include hypovolaemia, low LV afterload, LV systolic dysfunction, LV diastolic dysfunction, RV systolic dysfunction, and cardiac tamponade. An integrated approach to the difficult diagnosis is also provided.","PeriodicalId":153040,"journal":{"name":"Practical Perioperative Transoesophageal Echocardiography","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131007355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1093/med/9780198759089.003.0011
D. Sidebotham, A. Merry, M. Legget, Gavin Wright
Chapter 11 is a new chapter from earlier editions of Practical Perioperative Transoesophageal Echocardiography. It provides a concise review of the TOE considerations for patients undergoing AV repair. A classification of aortic regurgitation, as it pertains to valve repair, is presented and the key echocardiographic measurements that assist with surgical decision-making are outlined. The surgical techniques of AV repair are briefly summarized. The final section of the chapter outlines TOE assessment following repair, including the key measurements that are predictive of the durability of the repair.
{"title":"Aortic valve repair","authors":"D. Sidebotham, A. Merry, M. Legget, Gavin Wright","doi":"10.1093/med/9780198759089.003.0011","DOIUrl":"https://doi.org/10.1093/med/9780198759089.003.0011","url":null,"abstract":"Chapter 11 is a new chapter from earlier editions of Practical Perioperative Transoesophageal Echocardiography. It provides a concise review of the TOE considerations for patients undergoing AV repair. A classification of aortic regurgitation, as it pertains to valve repair, is presented and the key echocardiographic measurements that assist with surgical decision-making are outlined. The surgical techniques of AV repair are briefly summarized. The final section of the chapter outlines TOE assessment following repair, including the key measurements that are predictive of the durability of the repair.","PeriodicalId":153040,"journal":{"name":"Practical Perioperative Transoesophageal Echocardiography","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128557784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1093/MED/9780198759089.003.0015
D. Sidebotham, A. Merry, M. Legget, Gavin Wright
The chapter begins with a description of the relevant anatomy and physiology of the TV complex. Relevant TOE views—including additional views to those presented in Chapter 4: Standard views—are described. In the next two sections, the aetiology and echocardiographic assessment of tricuspid regurgitation and tricuspid stenosis are presented. A guideline-based approach to quantifying severity is described. The indications for TV surgery are discussed. An approach to assessing patients following TV repair is outlined. In the final section, the causes and assessment of PV disease are briefly discussed.
{"title":"The tricuspid and pulmonary valves","authors":"D. Sidebotham, A. Merry, M. Legget, Gavin Wright","doi":"10.1093/MED/9780198759089.003.0015","DOIUrl":"https://doi.org/10.1093/MED/9780198759089.003.0015","url":null,"abstract":"The chapter begins with a description of the relevant anatomy and physiology of the TV complex. Relevant TOE views—including additional views to those presented in Chapter 4: Standard views—are described. In the next two sections, the aetiology and echocardiographic assessment of tricuspid regurgitation and tricuspid stenosis are presented. A guideline-based approach to quantifying severity is described. The indications for TV surgery are discussed. An approach to assessing patients following TV repair is outlined. In the final section, the causes and assessment of PV disease are briefly discussed.","PeriodicalId":153040,"journal":{"name":"Practical Perioperative Transoesophageal Echocardiography","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126749704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1093/med/9780198759089.003.0013
D. Sidebotham, A. Merry, M. Legget, Gavin Wright
The first part of Chapter 13 outlines an approach to imaging different types of prosthetic valves, including a description of optimal views and potential pitfalls encountered when imaging mechanical and bioprosthetic valves in the aortic and mitral positions. Next, the techniques of haemodynamic assessment of prosthetic valves (pressure gradients, valve areas, pressure half-time) are described. Normal pressure gradients and calculated valve areas for selected valves are provided in tabular form. The concepts of pressure recovery and patient–prosthesis mismatch are explained. The features of prosthetic valve regurgitation (normal versus abnormal, transvalvular versus paravalvular) are then reviewed. In the final section, the causes of pathological stenosis and regurgitation are discussed, including thrombus formation, endocarditis, calcific degeneration, and valve dehiscence.
{"title":"Prosthetic valves","authors":"D. Sidebotham, A. Merry, M. Legget, Gavin Wright","doi":"10.1093/med/9780198759089.003.0013","DOIUrl":"https://doi.org/10.1093/med/9780198759089.003.0013","url":null,"abstract":"The first part of Chapter 13 outlines an approach to imaging different types of prosthetic valves, including a description of optimal views and potential pitfalls encountered when imaging mechanical and bioprosthetic valves in the aortic and mitral positions. Next, the techniques of haemodynamic assessment of prosthetic valves (pressure gradients, valve areas, pressure half-time) are described. Normal pressure gradients and calculated valve areas for selected valves are provided in tabular form. The concepts of pressure recovery and patient–prosthesis mismatch are explained. The features of prosthetic valve regurgitation (normal versus abnormal, transvalvular versus paravalvular) are then reviewed. In the final section, the causes of pathological stenosis and regurgitation are discussed, including thrombus formation, endocarditis, calcific degeneration, and valve dehiscence.","PeriodicalId":153040,"journal":{"name":"Practical Perioperative Transoesophageal Echocardiography","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133935330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1093/MED/9780198759089.003.0019
D. Sidebotham, A. Merry, M. Legget, Gavin Wright
Chapter 19 is a short chapter in which TOE imaging for patients undergoing thoracic transplantation is reviewed. As expected, the chapter is divided into two sections: heart transplantation and lung transplantation. For each section, pre-transplant, post-transplant, and late assessment are discussed. The heart transplant section also covers the echocardiographic evaluation of the donor heart. Particular points that are covered include the assessment of the RV function—following both heart and lung transplantations—and the evaluation of the pulmonary veins following lung transplantation.
{"title":"Heart and lung transplantation","authors":"D. Sidebotham, A. Merry, M. Legget, Gavin Wright","doi":"10.1093/MED/9780198759089.003.0019","DOIUrl":"https://doi.org/10.1093/MED/9780198759089.003.0019","url":null,"abstract":"Chapter 19 is a short chapter in which TOE imaging for patients undergoing thoracic transplantation is reviewed. As expected, the chapter is divided into two sections: heart transplantation and lung transplantation. For each section, pre-transplant, post-transplant, and late assessment are discussed. The heart transplant section also covers the echocardiographic evaluation of the donor heart. Particular points that are covered include the assessment of the RV function—following both heart and lung transplantations—and the evaluation of the pulmonary veins following lung transplantation.","PeriodicalId":153040,"journal":{"name":"Practical Perioperative Transoesophageal Echocardiography","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132102118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1093/med/9780198759089.003.0005
D. Sidebotham, A. Merry, M. Legget, Gavin Wright
Chapter 5 is divided into two sections. In Section 1, anatomical variants that can lead to misdiagnosis or that are associated with cardiac pathology are described. Anatomical variants are grouped by location, starting with those in the right atrium and sequentially covering the LA, atrial septum, RV, LV, heart valves, pericardium, and extracardiac structures. In Section 2, cardiac masses and abnormal spaces are reviewed, including thrombi, vegetations, cysts, and tumours. The differences in echo reflectance of different cardiac masses is explained. For cardiac tumours, the incidence and characteristics of primary versus secondary and benign versus malignant lesions are described.
{"title":"Anatomical variants and cardiac masses","authors":"D. Sidebotham, A. Merry, M. Legget, Gavin Wright","doi":"10.1093/med/9780198759089.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780198759089.003.0005","url":null,"abstract":"Chapter 5 is divided into two sections. In Section 1, anatomical variants that can lead to misdiagnosis or that are associated with cardiac pathology are described. Anatomical variants are grouped by location, starting with those in the right atrium and sequentially covering the LA, atrial septum, RV, LV, heart valves, pericardium, and extracardiac structures. In Section 2, cardiac masses and abnormal spaces are reviewed, including thrombi, vegetations, cysts, and tumours. The differences in echo reflectance of different cardiac masses is explained. For cardiac tumours, the incidence and characteristics of primary versus secondary and benign versus malignant lesions are described.","PeriodicalId":153040,"journal":{"name":"Practical Perioperative Transoesophageal Echocardiography","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123604330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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