March 2014 A&A Video Summary

Video Author: Edward C. Nemergut, MD
Published on: 02.21.2014
Associated with: March 2014, Volume 118, Issue 3;

March summary of featured articles in Anesthesia & Analgesia for April 2014.

All Videos
Most Viewed
Most Emailed



Creator: Jeanette Esau
Duration: 1:58
Video summary of featured articles in Anesthesia & Analgesia for September 2017.
Creator: Dr Lachlan F. Miles
Duration: 1:17
Two- and three-dimensional imaging of the aortic valve in short axis, demonstrating differences in flow between the perimembranous VSD and the aorto-right ventricular fistula. The mid-esophageal aortic valve short axis view is used. In short-axis imaging, it is particularly difficult to appreciate the differences in flow arising above and below the plane of the aortic valve annulus.
Creator: Dr Lachlan F. Miles
Duration: 1:08
Two- and three-dimensional imaging of the aortic valve in the long axis in both mid-esophageal five chamber and the mid-esophageal long axis and modified mid-esophageal aortic valve short axis views. The full course of the fistula tract is difficult to appreciate without color flow Doppler. The change in perspective to long axis allows the viewer to distinguish between flow through the VSD (in systole) and the aorto-right ventricular fistula (in diastole).
Creator: Dr Lachlan F. Miles
Duration: 1:01
Two- and three-dimensional imaging of the left and right ventricular outflow tract using the transgastric left ventricular long axis view. The distance of the area of interest from the transducer decreases spatial resolution. Furthermore, the path of the fistula relative to the probe in this position precludes satisfactory Doppler alignment.
Creator: Jeanette Esau
Duration: 2:24
Video summary of featured articles in Anesthesia & Analgesia for August 2017.
Creator:
Duration: 0:15
Real-time ultrasound-guided left supraclavicular approach to the central vein
Creator:
Duration: 0:15
Identify the right jugular vein and carotid artery at the level of the thyroid cartilage on the short-axis view. Then, the probe is moved caudally following the internal jugular vein in the center of the monitor. Once the probe has reached the clavicle, it is inclined following the internal jugular vein to identify where it merges with the right subclavian vein and the underlying pleura on the long-axis view. The puncture needle is inserted using the long-axis view and advanced while identifying the needle point in real-time, until it reaches the right brachiocephalic vein.
Creator:
Duration: 0:06
The correct insertion of guide wire into the vein should be confirmed via ultrasound before the dilation and catheter insertion.
Creator: Dr. Saikat Bandyopadhyay
Duration: 0:55
The tumor is attached to the inter-atrial septum and protrudes into the RV cavity in diastole. Parts of the tumor are imaged in the right ventricular outflow tract. The mean gradient across the tricuspid valve was 1.93 mm Hg. (Abbreviations: RA = Right atrium, LA = Left atrium, RV = Right ventricle, LV = Left ventricle, PA = Pulmonary artery, RVOT = Right ventricular outflow tract, IVC = Inferior vena cava, SVC = Superior vena cava).
Creator: Dr. Saikat Bandyopadhyay
Duration: 1:05
In the pre-cardiopulmonary bypass (CPB) period tumor fragments are seen adjacent to the IVC cannula as well as inside the IVC and hepatic vein, after advancement of the IVC cannula into the IVC. Post initiation of CPB, tumor fragments are seen abutting the tip of the IVC cannula.
Creator: Dr. Saikat Bandyopadhyay
Duration: 1:04
No tumor fragments or residual tumor were found during this examination however significant RV dilation and hypokinesis is noted. No inter-atrialcommunication was seen with color flow Doppler.
Creator: Juan G. Ripoll
Duration: 0:24
Initially, by using a two-dimensional transthoracic echocardiography IVC subcostal view, the Avalon Elite catheter was not visualized within the inferior vena cava (IVC). Upon successful catheter repositioning, the catheter was imaged inside the IVC.
Creator: Juan G. Ripoll
Duration: 0:25
Under two-dimensional transthoracic echocardiography parasternal right ventricular inflow tract view, Color flow Doppler was utilized to assess adequate catheter positioning. Avalon Elite catheter outflow/reinfusion port is imaged and flow is directed towards the tricuspid valve.
Creator:
Duration: 0:27
First part: The modified ME5ch view demonstrates two masses (“proximal” and “distal”). The echogenicity of the distal mass is lower than that of the proximal mass. Second part: Simultaneous orthogonal plane to the proximal mass. Third part: Simultaneous orthogonal plane to the distal mass. Fourth part: Color flow Doppler (CFD) analysis in the ME bicaval view. Fifth part: ME RV inflow-outflow view. Sixth part: CFD analysis in the ME RV inflow-outflow view. Seventh part: ME 4-chamber view. Eighth part: CFD analysis in the ME 4-chamber view. ‘#’ indicates intra-mass calcification.
Creator:
Duration: 0:24
First part: The ME view, obtained by slightly withdrawing the probe from the modified ME 5-chamber view in video clip 1, demonstrates two cardiac masses (“proximal” and “distal”), with the RCA penetrating the left side of the distal mass. Second part: Color flow Doppler reveals laminar blood flow in the RCA. Third part: Simultaneous orthogonal planes to the RCA based on the ME aortic valve short axis view. Fourth part: Simultaneous orthogonal planes to the tricuspid valve based on the modified trans-gastric RV inflow-outflow view.
Creator:
Duration: 0:15
First part: Superior view. 3D data was acquired with a 4-beat gated full volume mode, based on a modified ME 5ch view. The superior wall of the RA is partially cropped. Second part: The RA view was obtained after rotating the data set of the first part with a 90º up-down rotation to locate the SVC at the 12 o’clock position and a 90º rotation around the vertical axis on the screen. The echogenicity of the distal mass is lower than that of the proximal mass. ‘#’ indicates intra-tumor calcification in the distal mass.
Creator: Jeanette Esau
Duration: 2:26
Video summary of featured articles in Anesthesia & Analgesia for July 2017.
Creator: Adobe Premiere Pro CC
Duration: 0:20
Midesophageal short-axis view of the aortic valve shows a localized mass (arrow) in the left main coronary artery.
Creator: Quick time
Duration: 0:16
ME 4-chamber view showing intermittent tricuspid prosthesis regurgitation
Creator: Quick time
Duration: 0:10
ME- 4 chamber showing abnormal regurgitation in all cycles



Creator: Jeanette Esau
Duration: 1:58
Video summary of featured articles in Anesthesia & Analgesia for September 2017.
Creator: Dr Lachlan F. Miles
Duration: 1:17
Two- and three-dimensional imaging of the aortic valve in short axis, demonstrating differences in flow between the perimembranous VSD and the aorto-right ventricular fistula. The mid-esophageal aortic valve short axis view is used. In short-axis imaging, it is particularly difficult to appreciate the differences in flow arising above and below the plane of the aortic valve annulus.
Creator: Dr Lachlan F. Miles
Duration: 1:08
Two- and three-dimensional imaging of the aortic valve in the long axis in both mid-esophageal five chamber and the mid-esophageal long axis and modified mid-esophageal aortic valve short axis views. The full course of the fistula tract is difficult to appreciate without color flow Doppler. The change in perspective to long axis allows the viewer to distinguish between flow through the VSD (in systole) and the aorto-right ventricular fistula (in diastole).
Creator: Dr Lachlan F. Miles
Duration: 1:01
Two- and three-dimensional imaging of the left and right ventricular outflow tract using the transgastric left ventricular long axis view. The distance of the area of interest from the transducer decreases spatial resolution. Furthermore, the path of the fistula relative to the probe in this position precludes satisfactory Doppler alignment.
Creator: Jeanette Esau
Duration: 2:24
Video summary of featured articles in Anesthesia & Analgesia for August 2017.
Creator:
Duration: 0:15
Real-time ultrasound-guided left supraclavicular approach to the central vein
Creator:
Duration: 0:15
Identify the right jugular vein and carotid artery at the level of the thyroid cartilage on the short-axis view. Then, the probe is moved caudally following the internal jugular vein in the center of the monitor. Once the probe has reached the clavicle, it is inclined following the internal jugular vein to identify where it merges with the right subclavian vein and the underlying pleura on the long-axis view. The puncture needle is inserted using the long-axis view and advanced while identifying the needle point in real-time, until it reaches the right brachiocephalic vein.
Creator:
Duration: 0:06
The correct insertion of guide wire into the vein should be confirmed via ultrasound before the dilation and catheter insertion.
Creator: Dr. Saikat Bandyopadhyay
Duration: 0:55
The tumor is attached to the inter-atrial septum and protrudes into the RV cavity in diastole. Parts of the tumor are imaged in the right ventricular outflow tract. The mean gradient across the tricuspid valve was 1.93 mm Hg. (Abbreviations: RA = Right atrium, LA = Left atrium, RV = Right ventricle, LV = Left ventricle, PA = Pulmonary artery, RVOT = Right ventricular outflow tract, IVC = Inferior vena cava, SVC = Superior vena cava).
Creator: Dr. Saikat Bandyopadhyay
Duration: 1:05
In the pre-cardiopulmonary bypass (CPB) period tumor fragments are seen adjacent to the IVC cannula as well as inside the IVC and hepatic vein, after advancement of the IVC cannula into the IVC. Post initiation of CPB, tumor fragments are seen abutting the tip of the IVC cannula.
Creator: Dr. Saikat Bandyopadhyay
Duration: 1:04
No tumor fragments or residual tumor were found during this examination however significant RV dilation and hypokinesis is noted. No inter-atrialcommunication was seen with color flow Doppler.
Creator:
Duration: 0:27
First part: The modified ME5ch view demonstrates two masses (“proximal” and “distal”). The echogenicity of the distal mass is lower than that of the proximal mass. Second part: Simultaneous orthogonal plane to the proximal mass. Third part: Simultaneous orthogonal plane to the distal mass. Fourth part: Color flow Doppler (CFD) analysis in the ME bicaval view. Fifth part: ME RV inflow-outflow view. Sixth part: CFD analysis in the ME RV inflow-outflow view. Seventh part: ME 4-chamber view. Eighth part: CFD analysis in the ME 4-chamber view. ‘#’ indicates intra-mass calcification.
Creator:
Duration: 0:24
First part: The ME view, obtained by slightly withdrawing the probe from the modified ME 5-chamber view in video clip 1, demonstrates two cardiac masses (“proximal” and “distal”), with the RCA penetrating the left side of the distal mass. Second part: Color flow Doppler reveals laminar blood flow in the RCA. Third part: Simultaneous orthogonal planes to the RCA based on the ME aortic valve short axis view. Fourth part: Simultaneous orthogonal planes to the tricuspid valve based on the modified trans-gastric RV inflow-outflow view.
Creator:
Duration: 0:15
First part: Superior view. 3D data was acquired with a 4-beat gated full volume mode, based on a modified ME 5ch view. The superior wall of the RA is partially cropped. Second part: The RA view was obtained after rotating the data set of the first part with a 90º up-down rotation to locate the SVC at the 12 o’clock position and a 90º rotation around the vertical axis on the screen. The echogenicity of the distal mass is lower than that of the proximal mass. ‘#’ indicates intra-tumor calcification in the distal mass.
Creator: Jeanette Esau
Duration: 2:26
Video summary of featured articles in Anesthesia & Analgesia for July 2017.
Creator: Adobe Premiere Pro CC
Duration: 0:20
Midesophageal short-axis view of the aortic valve shows a localized mass (arrow) in the left main coronary artery.
Creator: Quick time
Duration: 0:16
ME 4-chamber view showing intermittent tricuspid prosthesis regurgitation
Creator: Quick time
Duration: 0:10
ME- 4 chamber showing abnormal regurgitation in all cycles
Creator: Quick time
Duration: 0:09
ME-4 chamber view showing resolution of the intraprosthetic regurgitation
Creator: i-movie
Duration: 0:18
Prebypass mid-esophageal view of the left atrial appendage showed no thrombus by 2 D images, and no filling defect by color flow Doppler at orthognal views. Please notice the prominent pectinate muscle (arrow).
Creator: Jeanette Esau
Duration: 2:57
Video summary of featured articles in Anesthesia & Analgesia for June 2017.
Creator: Jeanette Esau
Duration: 2:37
Video summary of featured articles in Anesthesia & Analgesia for May 2017.
Creator: Luiz F Maracaja MD
Duration: 0:21
1.The imaging acquisition starts with a standard ME 2-chamber view. In this view, the left main coronary artery (LMCA) or CX frequently is visualized in SAX view underneath the left atrial appendage. 2. Activate the orthogonal imaging and move the cursor directly into the vessels located in the atrioventricular groove just underneath the left atrial appendage, which could be the CX, LMCA, or GCV. The orthogonal plane displays a longitudinal view, allowing differentiation of these vessels by showing the LMCA continuous with the CX and frequently a short segment of the LAD. 3. Adjust the position of the color flow Doppler (CFD) sector, focusing on the atrioventricular groove, and use low-velocity scale (15–30 cm/s). Reducing the CFD sector size will increase the resolution, improve the frame rate, and enhance flow imaging.
Creator: Luiz F Maracaja MD
Duration: 0:08
1. Start at the 2D ME AV SAX or LAX view, focusing on the right SoV during the delivery antegrade cardioplegia. 2. Activate the orthogonal imaging and aim the cursor to the middle of the right SoV. 3. Adjust size and position of the CFD sector and use low-velocity scale (15–30 cm/s). 4. Acquiring and reviewing the loop with slower cine speed allows better display of the RCA color flow.
Creator: Luiz F Maracaja MD
Duration: 0:15
1. Starting with ME 2-chamber view, activate the orthogonal imaging by aiming the cursor into the atrioventricular groove underneath the left atrial appendage lateral to the CX. 2. Activate CFD with a low-velocity scale (15–30 cm/s). Then, by moving the CFD sector over the atrioventricular groove lateral to the CX, one can display an image of the great cardiac vein (GCV) 3. The orthogonal plane displays retrograde blood cardioplegia flowing anteriorly from the coronary sinus (CS) to GCV and tributaries. The GCV wraps around the left side of the heart and posteriorly merges with the CS.
Creator: J. Kirk Edwards, MD
Duration: 0:07
2D transesophageal echo (TEE) view of the mid-esophageal (ME) color Doppler x-plane of the short axis (SAX) and long axis (LAX). Color Doppler displays moderate to severe eccentric aortic insufficiency (AI) directed away from the noncoronary leaflet.
Creator: J. Kirk Edwards, MD
Duration: 0:09
3D transesophageal echo (TEE) of the aortic root, obliquely looking towards the right and noncoronary leaflets with an overriding dissection flap.
Creator: J. Kirk Edwards, MD
Duration: 0:07
3D transesophageal echo (TEE) en-face view of the aortic root and valve from the aortic perspective. The false lumen is seen overriding the noncoronary leaflet, with extension over the right coronary leaflet.
Creator: Jeanette Esau
Duration: 3:11
Video summary of featured articles in Anesthesia & Analgesia for March 2017.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 23:23
A brief, screen-in-screen review of the techniques required to perform bedside cardiac ultrasound at the parasternal, apical, and subcostal windows.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:08
The right ventricle is under the transducer. There is normal excursion and coaptation of the aortic and mitral valves. The chambers are normal in size. There is brisk excursion of the aortic root, brisk opening of the mitral valve, a normal descent of the base of the MV, and normal thickening of the left ventricular segments.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:06
The aortic valve is heavily calcified and does not open well. The degree of stenosis cannot be quantified from this view, but with excursion this limited the assumption should be that the patient has severe stenosis until it is proven otherwise. In addition to aortic valve calcification, the mitral annulus is heavily calcified, there is left ventricular hypertrophy, and the left atrium is enlarged.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:08
The RVOT, LA, and LV are all dilated and appear proportionally large compared to the aortic annulus and root. Compare the relative sizes with Video 1 (normal PLAX.) There is evidence of decreased LV systolic function, with decreased motion of the aortic root, decreased excursion of the anterior mitral leaflet, decreased mitral annular excursion, and decreased thickening of the left ventricular segments. There is also a left pleural effusion.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:05
Left ventricular and aortic valve function appear normal. There is thickening of the tips of the mitral leaflets, with diastolic bowing seen particularly in the anterior mitral leaflet (the “hockey stick” appearance). The left atrium appears enlarged as well, consistent with elevated left atrial pressure from mitral stenosis.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:07
Multiple beats are shown in this clip and the image does not remain still because the patient was severely dyspneic. The patient has significant hypertrophy of the anterioseptal wall of the left ventricle. In multiple cardiac cycles the anterior mitral leaflet can be seen to impinge on the left ventricular outflow tract.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:06
The thinning of this segment suggests a scar consistent with previous myocardial infarction.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:07
A pericardial effusion around the heart, hyperdynamic left ventricular systolic function, and decreased LV filling in diastole.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:07
Septic shock, decreased left ventricular (LV) afterload, and increased cardiac output. The LV is full in diastole and empty in systole, consistent with the patient’s low-afterload state.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:08
The interventricular septum (IVS) is normally convex with respect to the left left ventricle throughout the cardiac cycle. In this case the IVS is flat in both systole and diastole, suggesting that the right and left ventricular pressures are similar (near systemic pulmonary artery pressures.)
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:08
The apex of the left ventricle is directly under the ultrasound transducer. All four chambers can be visualized. There is normal global and regional biventricular systolic function, normal excursion and coaptation of the mitral and tricuspid valves, and normal chamber sizes.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:11
A large portion of the myocardium at the LV apex is not thickening. There is decreased global LV systolic function and left atrial enlargement as well.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:09
Prolapse of both anterior and posterior mitral leaflets with left atrial enlargement.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:09
Abnormal mitral valve opening in a patient with rheumatic heart disease. The tips of the mitral leaflets are thickened. The left atrium appears qualitatively enlarged compared with the size of the left ventricle.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:09
Enlarged right ventricle with decreased RV systolic function in a patient with a history of chronic severe pulmonary hypertension.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:10
Subcostal four chamber with right ventricular dilation and hypertrophy. The free wall of the RV appears as thick as the left ventricle. The RV appears larger than the LV, suggesting significant enlargement.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:11
Subcostal four chamber in a patient with pericardial effusion and tamponade. The effusion is seen as a large echolucent space around the heart. The right atrium appears collapsed in ventricular systole and the right ventricle appears compressed in ventricular diastole. These findings are both consistent with tamponade physiology.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:19
The liver is at the top of the screen, with the thin-walled IVC seen entering the right atrium. There is more than 50% collapse of the IVC when the patient sniffs.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:10
Subcostal IVC in a patient with cardiac tamponade. The IVC appears dilated and does not collapse as the patient sniffs.
Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:14
Subcostal IVC in a patient with hypovolemia. The IVC is small and collapses completely as the patient breathes.
Creator: Jeanette Esau
Duration: 2:33
Video summary of featured articles in Anesthesia & Analgesia for February 2017.
Creator: Jeanette Esau
Duration: 3:50
Video summary of featured articles in Anesthesia & Analgesia for January 2017.
Creator: Jeanette Esau
Duration: 1:31
Video summary of featured articles in Anesthesia & Analgesia for June 2016.
Creator: Jeanette Esau
Duration: 1:41
Video summary of featured articles in Anesthesia & Analgesia for May 2016.
Creator: Jeanette Esau
Duration: 1:39
Video summary of featured articles in Anesthesia & Analgesia for March 2016.
Creator: Jeanette Esau
Duration: 1:48
Video summary of featured articles in Anesthesia & Analgesia for January 2016.
Creator: Jeanette Esau
Duration: 1:48
Video summary of featured articles in Anesthesia & Analgesia for September 2015.
Creator: Jeanette Esau
Duration: 1:51
Video summary of featured articles in Anesthesia & Analgesia for June 2015.
Creator: Jeanette Esau
Duration: 1:55
Video summary of featured articles in Anesthesia & Analgesia for April 2015.
Creator: Steven Sayre
Duration: 3:08
Video summary of featured articles in Anesthesia & Analgesia for January 2015
Creator: Edward C. Nemergut, MD
Duration: 5:06
Video summary of featured articles in Anesthesia & Analgesia for September 2014.