Lecture 1-Into to the Comprehensive exam. This lecture has the following goals: 1. Introduce the utility, indications, limitations and contraindications of TEE. 2. Discuss the need for a comprehensive TEE exam. 3. Discuss how to perform a comprehensive perioperative TEE exam.
Lecture 1-Into to the Comprehensive exam. This lecture has the following goals: Introduce the utility, indications, limitations and contraindications of TEE Discuss the need for a comprehensive TEE exam Discuss how to perform a comprehensive perioperative TEE exam
Lecture 1-Into to the Comprehensive exam. This lecture has the following goals: Introduce the utility, indications, limitations and contraindications of TEE Discuss the need for a comprehensive TEE exam Discuss how to perform a comprehensive perioperative TEE exam
Indications and Contraindications
Controls and Background
Knobology and Image Optimization Part 2
Compression and Dynamic Range
This lecture involves an introduction to Doppler ultrasound.
ERROR-Doppler Additional Topics part 1 at 17:02 Option A is rightfully incorrect also, as the HIGH PASS wall filter eliminates low velocity signals which are due to tissue motion. Tissue motion has low velocity high amplitude signals so in that sense the HIGH PASS wall filter does eliminate high amplitude signals due to tissue motion. High pass wall filters eliminated low frequency and high amplitude signals Low pass wall filters eliminated high frequency and low amplitude signals There is also confusion regarding the “REJECT” function of the ultrasound receiver, as some systems use the terms wall filter and reject interchangeably, YIKES. Sorry for the confusion. Special thanks to Tariq Naseem and Antonio Hernandez and others who alerted us to the error. We will re-record the lecture and remove the error when time permits. Sorry for the mistake.
Doppler Ultrasound (Additional Topics Part 2)
Doppler Ultrasound (Additional Topics Part 3)
Doppler Ultrasound (Additional Topics Part 4)
This lecture discusses basic systolic function. Note: Myocardial perfusion is variable in patients (we are all unique) and the perfusion of the various 17 segments presented in this lecture was the same as the perfusion used by the ASE/SCA/AHA/NBE for many years. In 2013 the ASE produced a NEW BASIC EXAM guidelines PDF with slightly different wall segment perfusion. IT IS CRITICAL THAT YOU DOWNLOAD AND READ THIS PDF. Here is the link:http://www.asecho.org/wordpress/wp-content/uploads/2013/05/Basic-Perioperative-TEE-Exam.pdf On page 449 of this article there is a figure describing perfusion of the myocardial segments. This is the perfusion I would use for the basic exam. Sorry for any confusion this has created. Myocardial perfusion varies from patient to patient and the guidelines are a moving target as well. Please give me a shout if you have questions: tommy@ptemasters.com ERROR: At around the 35:00 mark. The area of the LVOT is calculated using π x (diameter)2 instead of Pi
Skip BackSkip By (sec) 10 Skip Ahead Speed 1.0x PLEASE DOWNLOAD AND READ THE 2013 BASIC PERIOPERATIVE TEE EXAM GUIDELINES LINK: http://www.asecho.org/wordpress/wp-content/uploads/2013/05/Basic-Perioperative-TEE-Exam.pdf
This lecture discusses advanced systolic function. ERROR: Strain = [Final Length - Initial Length] / [Initial Length] or [L2-L1] / L1 Final Number is suppose to be negative. Special thanks to Tariq Naseem who alerted us to the error. We will re-record the lecture and remove the error when time permits. Sorry for the mistake
This lecture describes the TEE evaluation of the Aortic Valve Mistakes found: at 63:07 min a continuity eqn. calculation should say 2.9 cm squared. We say 2.9 cm cubed. We meant to say squared. We will re-record this when time allows.
Aortic Valve (Additional Topics)
This lecture has been broken into several parts for quicker streaming.
This lecture has been broken into several parts for quicker streaming.
ERROR: at 37:15 min we left out "alpha" /180 in the equation illustrated at the bottom of the slide. ERROR: Mitral Valve Part 3 lecture at 36:10, the EROA calculation should read: EROA = Rvol/TVImr = 13.1 cm3/191cm = 0.07 cm2 Special thanks to Trent Wray and others who alerted us to the error. We will re-record the lecture and remove the error when time permits. Sorry for the mistake. Error: Mitral Valve part 3 lecture 32 min:42 seconds – Table: Measures of MR. Moderate MR is 30-59 mL instead of 30-69 mL. Shoud say 30-59 for moderate as grreater than 60ml is severe! Thanks to Juan G. Ripoll for noticing this error!
This lecture has been broken into several parts for quicker streaming.
Mitral Valve (Additional Topics - Part 1)
This lecture discusses TEE evaluation of the right heart. There is a small error at time 29:49, the small diagram at the top left labels the SVC and the IVC incorrectly. Sorry for this small mistake. We will fix this ASAP. Thanks and Good luck.
Mistakes in this lecture: at About 12:28 we say LV when we meant RV. We Also misspelled architecture in one of the earlier slides in the same presentation.
The Right Heart Part 3
The Right Heart Part 4
RV Systolic Assessment by Fred Cobey Part 1
RV Systolic Assessment by Fred Cobey Part 2
Evaluation of TR by Fred Cobey, MD
This lecture discusses ASDs VSDs, AV canals, and TOF.
Congenital Heart Disease Additional Topics Part 1 at 03:10 ERROR: the peak velocity should be 4 x (1.3)2 = 6.8 mmHg Sorry for the error. Special thanks to Tariq Naseem, Steve Metcalf and others who alerted us to the error. We will re-record the lecture and remove the error when time permits. Sorry for the mistake
Congenital Heart Disease Additional Topics Part 2
Thanks to Dr Rob Forstot and others for pointing out that at around 10:15 #4 shoud be LA not RA. Sorry for the error thanks Rob!
Congenital Heart Disease Additional Topics Part 4
Congenital Heart Disease Additional Topics Part 5
Congenital Heart Disease Additional Topics Part 6
ERROR: Congenital Heart Disease Additional Topics Part 7 at 43:50 Choice B is also true, Ventriculoarterial discordance is present in D-transposition and L-transposition. Special thanks to Tariq Naseem and Antonio Hernandez and others who alerted us to the error. We will re-record the lecture and remove the error when time permits. Sorry for the mistake.
This lecture discusses basic and advanced hemodynamic calculations. ERROR: Hemodynamics Part 1 at 16:28. In the table it should say: Moderate regurgitant volume 30-59 ml and severe >60ml error at time 19:55: ROA = RVOL / TVI = 13.1/191 = 0.69 cm2 Special thanks to Keith Levendorf, Doug Carrie and others who alerted us to the errors. We will re-record the lecture and remove the error when time permits. Sorry for the mistake.
Hemodynamic Calculations Part 2
Hemodynamic Calculations Part 3 (Practice Questions!)
Hemodynamic Calculations Part 4 (Practice Questions!)
Hemodynamic Calculations Part 5 (Practice Questions!)
This lecture discusses the echocardiographic evaluation of the thoracic aorta.
This lecture describes the echocardiographic evaluation of diastolic function.
ERROR: Mistakes found: At about 21:50 we meant "a" when we said "e". ERROR: Te'-E is CORRECT. We incorrectly use TE-e' in this lecture. It is written BOTH ways TE-e' in the ASE guidelines and Te'-E in the original article. VERY confusing but the important thing to remember is: 1. Te' is PROLONGED with diastolic dysfunction. Te' is time from R on EKG to ONSET of e', TE is the time from R on EKG to onset of E wave. Te'-E is the difference: Te' minus TE. it is also called (incorrectly I think) TE-e' in the ASE guidelines 2. The TIME INTERVAL (Te'-E) is ALSO prolonged with diastolic dysfunction. Whatever you call it, it is prolonged. Te'-E is prolonged with diastolic dysfunciton and Te' is prolonged with diastolic dysfunction. Special thanks to Tariq Naseem and Antonio Hernandez and others who alerted us to the error. We will re-record the lecture and remove the error when time permits. Sorry for the mistake.
ERROR: Te'-E is CORRECT. We incorrectly use TE-e' in this lecture. It is written BOTH ways TE-e' in the ASE guidelines and Te'-E in the original article. VERY confusing but the important thing to remember is: 1. Te' is PROLONGED with diastolic dysfunction. Te' is time from R on EKG to ONSET of e', TE is the time from R on EKG to onset of E wave. Te'-E is the difference: Te' minus TE. it is also called (incorrectly I think) TE-e' in the ASE guidelines 2. The TIME INTERVAL (Te'-E) is ALSO prolonged with diastolic dysfunction. Whatever you call it, it is prolonged. Te'-E is prolonged with diastolic dysfunciton and Te' is prolonged with diastolic dysfunction. Special thanks to Tariq Naseem and Antonio Hernandez and others who alerted us to the error. We will re-record the lecture and remove the error when time permits. Sorry for the mistake.
Diastolic Function (Additional Topics Part 1)
Diastolic Function (Additional Topics Part 2)
Scott C. Streckenbach, M.D. (Director of perioperative echocardiography at Mass General Hospital, Harvard Medical School) discusses TEE assessment of prosthetic valves. Included are two pdf files of great value: PDF 19 is a copy of the slides discussed in the lecture, and PDF 20 is an outstanding discussion of prosthetic valves. We are immensely grateful to Dr Streckenbach for his contribution to this website.
Prosthetic Valves Cases (Part 1)