A proposed method to visualize the ductus arteriosus on transesophageal echocardiography

Abstract

The ductus arteriosus occupies a uniquely privileged position in the management of heart disease; it initiated not only the surgical management of congenital lesions but also the percutaneous management of this subset. During trans-thoracic echocardiography (TTE) the ductus is often visualized using 'high' parasternal (or the 'ductal' view) or suprasternal windows. It is generally agreed that imaging ductus during transesophageal echo (TEE) can be sub-optimal. During TEE imaging, visualization of the ductus arteriosus is obscured by the acoustic impedance offered by the left main bronchus; adjunct techniques such as insertion of a saline filled balloon in this airway have been used. We describe a simple maneuver that allows visualization of the patent ductus arteriosus during TEE imaging without the use of any adjuncts.

Role of transesophageal echocardiography in surgical retrieval of embolized amplatzer device and closure of coronary–cameral fistula

“…The natural history of CCF is variable. [ 1 4 8 9 ] Spontaneous closure of CCFs is very rare (1%–2%). [ 10 11 ] Patients with small fistula may remain asymptomatic throughout life.…”

“…Visualization of device in the LPA and continuous monitoring during surgical handling was facilitated using modified upper esophageal view described for visualization of patent ductus arteriosus (PDA) [ Video 2 ]. [ 4 ] After institution of cardiopulmonary bypass (CPB) and diastolic arrest with potassium-based cardioplegia fistula was visualized and closed with the PTFE patch through right atriotomy approach [ Figure 5a ]. Device retrieval was done through incision on pulmonary artery [ Figure 5b ].…”