#BSEcho2020 Brace yourself for take-off
Dr. Stephanie Curties on Ebstein's disease
🌟Ebstein's more than downward displacement of tricuspid valve --> 💥RV myopathy
🌟Echo: imaging modality of choice
🌟TR is usually severe
🌟variable morphology
🌟Look for associated lesions
#BSEcho2020 Dr. Curties: The forgotten and easily ignored tricuspid valve
🌟Thin leaflets <3 mm
🌟cords insert into 2 adjacent leaflets
🌟3 sets of PMs
🌟No fibrous continuity with PV
🌟Close to AV node #cardiacsurgery
#BSEcho2020 Dr. Curties:The three leaflets of the tricuspid valve
ANTERIOR: large, usually semicircular, infundibular, varying number of scallops
SEPTAL: small, semi-oval, medial, PM may be absent
POSTERIOR: smallest
#BSEcho2020 Dr. Bushra Rana @ImperialNHS on 3D Assessment of MR
✅Mechanism
....Type 1: Annular dilatation
....Type 2: Leaflet Proplapse
....Type 3: :leaflet restriction
✅Severity Assessment
✅Haemodynamic consequences
#BSEcho2020 ✅Severity Assessment
↔️Elliptical orifice (average Vena contract in orthogonal views)
↔️Multiple jets (3D Vena contract area)
↔️Late systolic jets (Volumetric methods)
Integrative approach to grading MR severity
VC area x MR VTI = Regurg Vol
#BSEcho2020 ✅Importance of haemodynamic consequences on outcome
➡️Class I: SYMPTOMS
or LVEF <60% but >30%, LVEDd >45 mm
➡️Class IIa: ASYMPTOMATIC
- AF, systolic PAP > 50 mmHg, LA > 60mls/m2, flail segment
➡️Class IIb:HIGH SURGICAL RISK GROUPS
@Medtronic PBL STOP
P↔️Presenting Rhythm:
Look at surface ECG and Markers. Markers are "your friends" telling you what the device is seeing and how the device is responding.
@Medtronic PBL STOP
B↔️Battery status (Voltage & Impedance):
Check appropriate rate change due to magnet application in @Medtronic devices ✅85 bpm