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Video 3: Post cardiopulmonary bypass (CPB) comprehensive TEE examination.

Video Author: Dr. Saikat Bandyopadhyay
Published on: 06.19.2017

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.

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Identification of the left ventricular access site with a finger. Midesophageal 2D TEE long-axis view at 130° (the indentation is on the left of the image sector, shown by arrow) and 3D TEE zoom-mode acquisition of the entry site (shown by asterisk).
Creator: Diana Zakarkaite
Duration: 0:09
Mitral valve P2 segment prolapse (Live 3D zoom MV “surgeon’s” view). The jaws of the device are opened in the left atrium, and the prolapsing P2 segment is captured.
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Video of ultrasound-guided dynamic needle tip positioning technique with synchronized live ultrasound view. The arterial puncture and the sequential advancement of the catheter and needle is shown with the corresponding ultrasound image.
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Creator: Massimiliano Meineri, MD
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Duration: 1:15
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Duration: 0:48
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Creator: Paolo Beccaria
Duration: 0:15
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Duration: 0:06
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Duration: 1:46
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Duration: 1:35
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Duration: 0:19
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Duration: 0:09
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Duration: 0:21
Mitral valve P2 segment prolapse (Live 3D zoom MV “surgeon’s” view). The jaws of the device are opened in the left atrium, and the prolapsing P2 segment is captured.
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Duration: 0:09
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Duration: 1:47
Video summary of featured articles in Anesthesia & Analgesia for March 2018.
Creator: Jeanette Esau
Duration: 02:09
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Creator: Roy Kiberenge
Duration: 0:55
Video of ultrasound-guided dynamic needle tip positioning technique with synchronized live ultrasound view. The arterial puncture and the sequential advancement of the catheter and needle is shown with the corresponding ultrasound image.
Creator: Massimiliano Meineri, MD
Duration: 1:16
A ME long axis view and a ME four chamber view are selected and analyzed using the Cardiac Motion Quantification (CMQ) analysis software package. First the aortic valve closure is identified and aortic valve closure time set. The ME four chamber is then selected and the LV long axis strain model is applied to the RV to allow correct labeling of septal segments. Tracking is qualitatively assessed and manually adjusted to capture the myocardium. The RV is divided into seven segments and the global strain is measured at – 29.8% with regional peak variability with all segments within limits of normal. RV Septum is de-selected to obtain RV free wall strain that is measured at -31.4%.
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Duration: 0:48
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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.
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ME-4 chamber view showing resolution of the intraprosthetic regurgitation
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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.
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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.
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The descending thoracic aorta is outside the pericardium, and a pericardial effusion will be seen extending between the heart and the aorta in this view while a pleural effusion will be seen deep and lateral to the aorta.
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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.
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Duration: 0:10
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Duration: 0:19
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Duration: 0:10
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