Hello Dr. Sadatian, I am currently preparing for the EU Certification in Adult Echocardiography and TOE (the ESC Certification). I have passed the theory exams and doing now the Logbook for both of them. I am facing an issue with imaging the deep trans gastric view aortic valve for the CW-Doppler Measurement, as it is a requirement for the Logbook. I am trying for over a month, whenever I get cases of severe aortic stenosis, but I never managed to get it right, most of the time it is impossible (due to air/artifacts/or cough and gag reflex from the patient, under mild sedation). Any other tipp in managing this view? because in theory it seems easy, but in practice much harder. Most of the internet images show very old clips (which means no one is doing it routinely and posting it nowadays), and IF the images are not old, there's always a normal aortic valve viewed. Would it be possible to post actually severe aortic stenosis with CW Doppler measurement from deep trans gastric view, as a loop to see the transition from TG SAX to deep TG? and next to the clip the manoeuvre required? I can only send a deep thank you, because I have used all the videos I needed for my theory exams from this channel. Your work is amazing! I plan to contact you on email, regarding other questions if that is ok.
Hi Dr Marro, Congratulations & thank you. As you noticed AV & LVOT views for gradient are most challenging views in TEE because of our restricted window. I I explained in this clip ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-wQr9rKhcsmA.htmlsi=Q73oxRu34acTQFU but I am going to to prepare a clip specific for that . Just for now , when you are advancing from TG to Deep (slowly) antiflex your probe until you see wall of gastric & foreshortened of LVOT (@ 12:25) then with anti or retroflex and left flex ( maybe a little counterclockwise wise) we try to make sound beam as much as possible parallel to the LVOT & Ao jet. depends on body habitus of pt sometimes turning pt to supine or elevating head side of pt help (last option)
Thank you, sir. I have learned a lot from your videos. I emailed you my latest clips yesterday. Could you please help me find out if I am having severe trouble now?
Thank you so much, Sir. I replied my symptoms. I remembered that I got hit on my chest by an elbow last year during a basketball game. Should that be the cause? May I ask is the prolapse cause the regurgitation or the regurgitation cause the prolapse?@@masteringEcho-US-cardiology
