Alessandra Joslin

Percutaneous Balloon Mitral Valvuloplasty #echofirst

Want to know the new enhancements of the #MitraClip #TriClip G5 system over G4? Watch my new series of @YouTube videos on my Channel, under the MitraClip/TriClip G5 Playlist. It features a lecture and a series of short demo videos. @MountSinaiHeart is proud to be one of the first sites in the world to evaluate and adopt this new technology. @gilberttangMD" target="_blank" rel="nofollow noopener">youtube.com/@gilberttangMD G5 vs G4 lecture: youtu.be/i5oeMMu-25s G5 demos: youtube.com/watch?v=aa2iTL… youtube.com/watch?v=D7DmQZ… youtube.com/watch?v=CGlSGl… youtube.com/watch?v=WS13qf… youtube.com/watch?v=YSyGm7… youtube.com/watch?v=Fe9b9l… youtube.com/watch?v=DPGFZf… youtube.com/watch?v=y4kek7… @AbbottCardio @MountSinaiNYC @IcahnMountSinai @DoctorKini @KHERA_MD @LucySafi @vonBardelebenRS @modine_thomas @hahn_rt @kentso987 @MiChen__ @OKhaliqueMD @azeemlatib @AndreaScotti21 @SyedZaidMD @TsuyoshiKaneko1 @m_taramasso

In Atrial Functional MR can get “Hamstringing”of posterior MV leaflet due to massive LA dilation;this “atriogenic” leaflet tethering is from displaced posterior annulus onto crest of LV inlet resulting in⬆️in annulopapillary distance restricting leaflet motion #echofirst

atrial functional mitral regurgitation📝 🔺Diastolic dysf, E/e′ ratio & LAVI ≥ 40 mL/m2 assoc w⬆️☠️not EOA 🔺AFMR presence more prognostic than EROA severity 🔺AFMR EROA orifice shape elliptical underestimates severity 🔺2/3 of pts w mod or >AFMR had AFib bit.ly/4cgBOTU

Review Intraoperative Transesophageal Echocardiographic Guidance in Cardiac Surgery doi.org/10.3390/jcdd12… #echofirst #Cardiology #iecho #CardioEd #EchoFirst

A previously fit and well 25-year-old woman with headaches ended up being diagnosed with papillary fibroelastoma (PFE). Read the case report titled Sea anemone invades the heart: Unusual lesion of the mitral valve in #JTCVS Techniques: doi.org/10.1016/j.xjtc…

1/ Strain Imaging in Echocardiography: A powerful tool for detecting subtle myocardial dysfunction, far beyond LVEF. Here’s why it’s transforming cardiology — and how you should be using it. A thread: #CardioTwitter #Echo #FOAMed

#TechniquesThursday: Researchers found robotic myxoma resection using an ultrasonic aspirator system is simple, safe, and reliable. Read more from Chibanishi General Hospital in #JTCVS Techniques: doi.org/10.1016/j.xjtc…

1/8 How often should patients with a bicuspid aortic valve (BAV) be monitored? Let’s break down the latest guidelines to help prevent complications like aortic dilation, aneurysm, or dissection

#echofirst & MR How to assess MR for proper decision making? Follow standardized echo protocol answering the following  questions: ❓ How much ❓Structural integrity  ❓Why  How much MR is there? 👉GL do recommend PISA & regurgitation volume & fraction MANY PITFALLS (N. Merke) 👉 shorturl.at/O24x3 👉GL asking for vena contracta 👉indirect parameter as E- wave inflow velocity > 1,2 m/s & DVI > 1,4 👉Pulmonary vein inflow reduction or flow reversal 🎯look at LV volumes as a simple byproduct of LV EF a parameter we all believe in 🎯look at forward stroke volume another parameter we do believe in 🎯never forget to do quality check by looking at RVOT SV & RVSV (in isolated MR LVOT SV = RVOT SV = RVSV) Structural Integrity 👉LVEDS? 👉LAVI? 👉sPAP Why?  Seen by 2D & 3D TTE first so often no need for TEE in diagnostic work up TEE needed if TTE inconclusive or for interventional planning of therapy SMR atrial vs ventricular PMR 2D: 👉Look at leaflet position using Mitralvalve annulus as reference plane 🎯leaflets flat (atrial SMR) 🎯leaflets pointing towards left ventricle (ventricular SMR) 🎯leaflets pointing towards left atrium (primary MR) Look at jet direction if eccentric or central Eccentric jet 🎯jet direction is pointing away from prolapse 🎯jet direction is pointing towards the tethered leaflet ventricular SMR or in case  of restricted posterior leaflet atrial SMR Central jet 🎯jet central in atrial SMR 🎯jet central in symmetrical tethered leaflets as in DCM ventricular SMR 🎯jet central in bileaflet prolapse in primary MR Timing of jet (use Color M Mode) 🎯holosystolic in atrial and ventricular SMR 🎯late systolic in primary MR 3D Using 3 apical views to achieve 3 datasets from the mitral valve including the. 👉entire valve apparatus, 👉landmarks as aortic valve, the left atrial appendage and the coronary sinus furthermore 👉avoid artifacts as air Use atrial perspective to image leaflet movement and direction 🎯primary MR shows leaflet displacement towards left atrium by using translumination facilitate by showing shadow as hint for prolapse 🎯secondary MR shows leaflet flat or from ventricular perspective pointing towards left ventricle Leaflet position in 2D & 3D, jet direction and jet timing will help to determine the WHY Report: Severe primary MR due to P2 Prolapse LV SV ml, LVOT SV ml, Reg. Vol. ml, Reg. Fraction % PISA not possible as jet is eccentric Vena contracta E wave > 1,2 m/s LV / LA dilated LV EF & GLS Always quality check look at RV SV & RVOT SV

The 10 Things to know about RV Function & discussion 🗣️ @ManiVannanheart #3DEchoBerlin @iamritu @denisamuraru @lpbadano @iamritu @DavidWienerMD @JaeKOh2 @alex1708ander @alexsfelixecho @NMerke @fiore_corrado

What’s in a name? most patients with MAD actually should be called Pseudo-MAD (apparent systolic MAD) part of myxomatous degeneration assoc w curling Pickelhaube arrhythmias but not a true anatomical substrate which is seen in sys & diastole #echofirst bit.ly/4jsK9an

@AntonioLJAraujo @RobinsonPoffo Thank you @AntonioLJAraujo

@AleJoslin @RobinsonPoffo Great work , congratulations

#echofirst of an outstanding #davinci robotic mitral valve repair 🤖 🫀 🇧🇷👨🏼‍⚕️Great work performed by @RobinsonPoffo

A giant and double-walled left atrial ball thrombus complicating a mitral stenosis. 🔗DOI: 10.1093/ehjcr/ytac443 #echofirst #CardioEd #FOAMed

Bicuspid aortic valve aortopathy can progress after valve replacement! This pt is 45 years post first op and 36 years post ball-in-cage AVR (still working) now with >5cm aneurysm #LifelongCare @ClevelandClinic #AortaCenter #StarrEdwards

(1/x) Here are the 10 biggest errors I see clinicians make while trying to learn #POCUS (aka: how to avoid common POCUS pitfalls) A 🧵

(1/x) A 'clot in transit' is a rare echo finding that when you see it, you might double guess yourself. Finding a clot in transit can be a game changer for the management of pulmonary embolism 🫁🩸 A 🧵of clot in transit cases (with some important mimics)

What an amazing skill and result of apical myectomy for #apicalHCM by @HSchaffMD ! Meticulously avoiding injury to papillary muscle. Presented at our annual #EchoNY. The procedure improves LV cavity size, LV filling pressure , and clinical outcome. @MayoClinicCVS @MayoClinicCV

@iamritu @ASE360 @VLSorrellImages @rajdoc2005 @NadeenFaza @NMerke @echo_stepbystep @DocStrom @purviparwani @onco_cardiology Great post and illustration, dear @iamritu 🌟🌟🌟 Many times in this kind of partial / distal cusp prolapse we find during surgical inspection also fenestrations, and sometimes very thin and friable leaflet tissue, imposing additional difficulty for repair.

First case of trans septal Sapien valve in degenerated Tedyne valve from London, UK. #EuroEcho2024 @ASE360 @KFAFHCards @mirvatalasnag @fayezbaraah @YaserNemshah @SACIS_KSA